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만성췌장염의 내시경적 치료

Roles of Endoscopic Intervention for Chronic Pancreatitis

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초록

만성췌장염 환자에서 내시경적 치료는 수술에 비해 상대적으로 비침습적으로 매우 안전하고 효과적인 치료법으로 확립되어 가고 있다. 특히 최근 내시경초음파유도하에 천자가 가능해지면서 내시경 시술과 연관된 합병증의 발생률이 낮아지고 내시경 치료의 성공률이 증가되고 있다. 하지만 만성췌장염의 합병증에서 임상경과가 매우 복잡한 경우에는 내시경 치료만으로 한계가 있음을 명확히 알아야 하고, 신중하게 평가하여 내시경적 치료 대상을 선정한다면 수술적 치료가 필요하지만 전신합병증으로 수술을 시행하지 못하는 환자에서 추후 수술을 할 수 있게 하는 가교역할과 다른 동반 질환으로 인해 수술이 불가능한 환자에서 수술을 대체할 수 있는 유용한 일차적 치료가 될 수 있다고 판단된다.

Abstract

Chronic pancreatitis is a debilitating disease with complications such as pancreatic duct stricture, duct stones, duct leak or fistulae, pseudocyst contributing to significant morbidity and mortality. Endoscopic intervention in patients with chronic pancreatitis compared to surgery has been known relatively safe and effective. Although there are several limitations, endoscopic intervention plays a specific role in carefully selected patients as primary interventional therapy when medical treatment was failed or patients are not suitable for surgery. In this review, we address the role of endoscopic intervention for chronic pancreatitis. (Korean J Med 2012;83:29-39)

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