胆石性胰腺炎的早期手术治疗  

The early operative treatment of gallstone pancreatitis

作　　者：周蒙滔[1] 张启瑜[1] 王春友[2] 施红旗[1] 周浩[1] 曾其强[1] 

机构地区：[1]温州医学院附属第一医院肝胆胰外科,浙江温州325000 [2]华中科技大学同济医学院附属协和医院胰腺外科中心,湖北武汉430022

出　　处：《中国普通外科杂志》2008年第2期127-129,共3页China Journal of General Surgery

摘　　要：目的探讨胆石性胰腺炎(GP)早期手术适应证及相应术式。方法回顾性分析136例采用早期手术治疗GP患者的临床资料。结果(1)梗阻性重型GP患者10例中8例采用早期手术治疗,全部治愈。(2)梗阻性轻型GP患者70例中57例采用早期手术治疗,全部治愈。(3)非梗阻性重型GP患者47例中13例采用单纯早期手术治疗,4例死于早期多脏器衰竭:另3例采用区域动脉灌注联合早期手术治愈。(4)非梗阻性轻型GP患者146例中采用早期手术55例,全部治愈。结论(1)梗阻性GP是早期手术的绝对适应证,胆道解压和胰周引流是其基本术式;(2)非梗阻性重型GP原则上不采用早期手术;(3)非梗阻性轻型GP可采用早期手术治疗。Objective To investigate the indications and appropriate method of early operative treatment of gallstone pancreatitis （ GP ） . Methods The clinical data of 136 cases of GP that underwent early operation were retrospectively analyzed. Results （ 1 ） Among 10 cases with severe obstructive GP, 8 cases underwent early operation, and all of them were cured. （2） Among 70 cases with mild obstructive GP, 57 cases underwent early operation, and all of those cases were cured. （ 3 ） In 47 cases with severe non-obstructive GP, 13 cases underwent simple early operation, and 4 of those cases died of early multiple organ failure, while 3 other cases treated by regional intra-arterial infusion combined with early operation were cured. （4） In 146 cases with mild non- obstructive GP, 55 cases underwent early operation, and all of those cases were cured. Conclusions （1）Obstructive GP is an absolute indication for early operation, and the basic operation is decompression of biliary tract obstruction and peri-pancreatic drainage. （ 2 ） In principle, cases of severe non-obstructive GP should not undergo early operation. （3）Early operation might be carried out in cases of mild non-obstructive GP.

关 键 词：胰腺炎/外科学 胰腺炎/继发性 胆结石/并发症 手术适应证 

分 类 号：R657.5[医药卫生—外科学]