全胰腺切除联合自体胰岛移植治疗慢性胰腺炎1例报道并文献复习

陈焕伟; 栾晓军; 刘成洋; 肖平; 甄作均; 邓斐文; 王峰杰; 刘颖; 许雪娟; 陈国强

doi:10.3969/j.issn.1674-7445.2018.06.010

全胰腺切除联合自体胰岛移植治疗慢性胰腺炎1例报道并文献复习

doi: 10.3969/j.issn.1674-7445.2018.06.010

528000 广东省佛山市第一人民医院胰腺外科（陈焕伟、甄作均、邓斐文、王峰杰、刘颖），风湿免疫科（陈国强），内分泌科（栾晓军、许雪娟），临床研究所（刘成洋、肖平）

基金项目:

2016年高校和医院科研创新平台项目 2016AG100561

详细信息

作者简介:
陈焕伟，男，1967年生，主任医师，研究方向为器官移植，Email：chwei_fsyyy@163.com

通讯作者:
陈国强，男，1965年生，主任医师，研究方向为免疫调节，Email：cgqiang@fsyyy.com

中图分类号: R617, R657.5
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- 文章访问数: 137
- HTML全文浏览量: 83
- PDF下载量: 29
- 被引次数: 0
出版历程
- 收稿日期: 2018-08-30
- 网络出版日期: 2021-01-19
- 刊出日期: 2018-11-15

Total pancreatectomy-islet autotransplantation in treatment of chronic pancreatitis: report of one case and literature review

Department of Pancreatic Surgery, the First People's Hospital of Foshan, Foshan 528000, China

More Information

Corresponding author: Chen Guoqiang, Email: cgqiang@fsyyy.com

摘要

摘要: 目的探讨全胰腺切除联合自体胰岛移植（TP-IAT）治疗慢性胰腺炎的临床疗效。方法佛山市第一人民医院对1例合并多发假性囊肿、胰腺结石的难治性慢性胰腺炎患者行TP-IAT治疗，并对其随访3个月的临床资料进行总结与分析。结果患者TP-IAT术后恢复顺利，无发生出血、严重低血糖等并发症，腹痛完全缓解，未服用镇痛药物。随访期间患者使用外源性胰岛素，空腹血糖控制理想，胰岛细胞功能部分恢复。结论 TP-IAT既能缓解慢性胰腺炎的临床症状，也能预防术后糖尿病的发生，是治疗难治性慢性胰腺炎的有效手段。
- 慢性胰腺炎 /
- 假性囊肿 /
- 胰腺结石 /
- 全胰腺切除 /
- 自体胰岛移植 /
- 糖尿病 /
- 胰岛素 /
- 低血糖
Abstract: Objective To evaluate the clinical efficacy of total pancreatectomy-islet autotransplantation (TP-IAT) in the treatment of chronic pancreatitis. Methods One patient diagnosed with refractory chronic pancreatitis complicated with multiple pseudocysts and pancreatic stones underwent TP-IAT in the First People's Hospital of Foshan. Clinical data were collected and analyzed during postoperative 3 months follow-up. Results The patient was well recovered after TP-IAT without complications, such as bleeding and severe hypoglycemia. Abdominal pain was completely relieved without taking analgesic drugs. During postoperative follow-up, the patient was treated with exogenous insulin, the fasting blood glucose was properly controlled and the function of islet cells was partially restored. Conclusions TP-IAT can not only relieve the clinical symptoms of chronic pancreatitis, but also prevent postoperative diabetes mellitus, which is an efficacious treatment of refractory chronic pancreatitis.
- Chronic pancreatitis /
- Pseudocyst /
- Pancreatic stone /
- Total pancreatectomy /
- Islet autotransplantation /
- Diabetes mellitus /
- Insulin /
- Hypoglycemia

HTML全文

图 1 本例慢性胰腺炎患者的影像学检查

A图为CT示胰尾部假性囊肿并病灶内出血; B图为CT示胰腺多发钙化并胰管结石; C图为MRI示慢性胰腺炎伴胰管扩张

Figure 1. Imaging examination of the patient with chronic pancreatitis

下载: 全尺寸图片幻灯片

图 2 胰岛的分离及纯化

A图为患者病胰胰管内充满胰腺结石; B图为显微镜下的单个胰岛细胞; C图为显微镜下的泥沙样胰腺结石

Figure 2. The isolation and purification of islet

下载: 全尺寸图片幻灯片

表 1 TP-IAT治疗慢性胰腺炎的多中心临床研究回顾

Table 1. Review of multi-center clinical study of TP-IAT in the treatment of chronic pancreatitis

研究作者	n	移植胰岛量（IE/kg）	术后1年生存率（%）	术后1年胰岛素脱离率（%）	术后1年疼痛缓解率（%）	术后生活质量评分
Sutherland DE, et al^[5]	409	-	98	30	85	改善
Garcea G, et al^[6]	60	-	-	21.6	90	-
Young MC, et al^[7]	97	4 308±2 689	100	35	-	-
Wilson GC, et al^[8]	166	-	94.6	38	73	改善
Ahmad SA, et al^[9]	45	4 933±5200	93	40	72	改善
Argo JL, et al^[10]	21	1 551±3680	100	0	60	-
Takita M, et al^[11]	17	5 279±5710	100	47	65	-
Walsh RM, et al^[12]	20	3 846（3 063~5 430）	100	-	70	改善
Tai DS, et al^[13]	9	4 899	100	44.4	100	改善
Bellin MD, et al^[14]	49	-	100	45	46	-
Johnston PC, et al^[15]	36	00003 333~6 845	94	33	-	-
Savari O, et al^[16]	10	02 478（685~6 002）	100	50	-	-
Dorlon M, et al^[17]	74	4 114	-	16	-	改善
Dixon J, et al^[18]	7	-	86	20	-	改善
Galvani CA, et al^[19]	6	2 301	100	-	100	改善
Fan CJ, et al^[20]	32	1 325±1 093	100	25	90	-
Solomina J, et al^[21]	20	2 980（681~5 229）	100	53	87	改善
-为原文未提供数据

下载: 导出CSV

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