慢性胰腺炎诊治指南(2014)

2014Ｒ576B1001－5256201503－0322－05Guidelinesforthemanagementofchronicpancreatitis2014GroupofPancreasSurgeryChineseSocietyofSurgeryChineseMedicalAssociation．Keywordspancreatitischronicdiagnosistherapyguidelinesdoi10．3969/j．issn．1001－5256．2015．03．0022015－02－11。chronicpancreatitisCPCP2008《》。、CP、。CP。1CP。、、。、。。2CP、、、、、、PＲSS1SPINK1CFTＲCP。。3CP、。CP。3．1。、。。、、、。3．23．2．1X。3．2．2EUSCP、、。EUS。3．2．3CTCTCP。。、、、。3．2．4MＲIMＲCPMＲICT。MＲCP、。MＲCPsecretin－enhancedMＲCPCP。3．2．5EＲCPCP。MＲCPEUS。3．2．6、CP。3．33．3．1、Lundh、/－－BT－PABA、Ⅰ13C－。22331320153JClinHepatolVol．31No．3Mar．2015。3．3．2CPⅢCHbA1c≥6．5%FBG≥7mmol/LC。90%。3．4、。CA19－9。IgG4、、、CP。3．5CP。。CTEUSEUS－FNAEUS－FNBcorebiopsy。3．6CP11CP2CP3451。12123、452。123．7。3．7CP4CP1CP1a．b．c．EＲCPd．EＲCP、a．MＲCPb．EＲCPc．CTd．EUS2“”34a．b．5622CP、、、、、、、1、2、、1。CA19－92、、、323．20145CP、、4。1、CT、EUS、EＲCP。2、。3、、、、。、。4、、、。66．1、。6．26．2．1。6．2．2、。3～41～2。。6．2．3、。CP。6．2．4、。CT、EUS、。6．2．5CP30～40mg/d2～42．5～5mg/d6～12。IgG4。6．3Oddi’s、、、。Oddi’sEST、、、ESTESWL。6．46．4．112、3、、、4。6．4．2、。、。6．4．3、EUS。。6．4．4Partington。Ｒoux－en－Y1。。。1Partington6．4．56．4．5．1、Oddi’s。PDPPPD。。6．4．5．2、CP。。42331320153JClinHepatolVol．31No．3Mar．20156．4．5．3。Ｒoux－en－Y2aΩ2b。2abΩ6．4．5．4、。。6．4．6+。Beger、Frey、IzbickiFreyBerne。6．4．6．1Begerduodenum－preservingpancreaticheadresectionDPPHＲCP。Ｒoux－en－Y3。Ｒoux－en－Y4。。PDPPPD。3Beger46．4．6．2Frey。Ｒoux－en－Y5。Beger。。5Frey6．4．6．3IzbickiFrey、、。Frey“V”、Ｒoux－en－Y6。6Izbicki6．4．6．4Berne523．2014－Ｒoux－en－Y7。BegerFrey、。7Berne6．4．7CP6．4．7．1。。、。。。。6．4．7．2。－。6．4．7．3。EＲCPMＲCP。。。6．4．7．4CP。。。7CP、。、、、CTHbA1c、。《2014》1DUFOUＲMADAMSONM．Theepidemiologyofalcohol－inducedpancreatitisJ．Pancrease2003274286－290．2SHIMOSEGAWATKATAOKAKKAMISAWATetal．There-visedJapaneseclinicaldiagnosticcriteriaforchronicpancreatitisJ．JGastroenterol2010456584－591．3CAHENDLGOUMADJNIOYetal．Endoscopicversussurgi-caldrainageofthepancreaticductinchronicpancreatitisJ．NEnglJMed20073567676－684．4YINZSUNJYINDetal．Surgicaltreatmentstrategiesinchro-nicpancreatitisameta－analysisJ．ArchSurg201214710961－968．5BACHMANNKTOMKOETTEＲLKUTUPAetal．IstheWhippleprocedureharmfulforlong－termoutcomeintreatmentofchronicpancreatitis15－yearsfollow－upcomparingtheoutcomeafterpylorus－preservingpancreatoduodenectomyandFreyproce-dureinchronicpancreatitisJ．AnnSurg20132585815－821．6WANGCLIUTWUHetal．Duodenum－preservingtotalpan-creaticheadresectionwithoutsegmentresectionoftheduodenumforchronicpancreatitisJ．LangenbecksArchSurg20093943563－568．7MAＲTNEZJABAD－GONZLEZAAPAＲICIOJＲetal．TheSpanishPancreaticClubrecommendationsforthediagnosisandtreatmentofchronicpancreatitispart1diagnosisJ．Pancre-atology20131318－17．8de－MADAＲIAEABAD－GONZLEZAAPAＲICIOJＲetal．TheSpanishPancreaticClub’srecommendationsforthediagnosisandtreatmentofchronicpancreatitispart2treatmentJ．Pan-creatology201313118－28．9MAYEＲLEJHOFFMEISTEＲAWEＲNEＲJetal．Chronicpan-creatitis－definitionetiologyinvestigationandtreatmentJ．DtschArzteblInt201311022387－393．10ISSAYBＲUNOMJBAKKEＲOJetal．TreatmentoptionsforchronicpancreatitisJ．NatＲevGastroenterolHepatol2014119556－564．GroupofPancreasSurgeryChineseSocietyofSurgeryChineseMedicalAssociation．Guidelinesforthemanagementofchronicpancreatitis2014J．JClinHepatol2015313322－326．inChinese．2014J．2015313322－326．62331320153JClinHepatolVol．31No．3Mar．2015