Case Report:Surgical intervention of severe post-ERCP-pancreatitis accompanied with duodenum perforation  

作　　者：Zuo-bing CHEN Zhong-yan LIANG Yun ZHANG Shao-yang ZHANG Shu-sen ZHENG 

机构地区：[1]Department of Emergency Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China [2]Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China

出　　处：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》2010年第1期17-21,共5页浙江大学学报（英文版）B辑（生物医学与生物技术）

基　　金：supported by the National Natural Science Foundation of China (No.30801188);the Natural Science Foundation of Zhejiang Province,China (Nos.Y2090443 and Y2090460)

摘　　要：Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure widely used to diagnose and treat conditions of biliary or pancreatic ductal system. The post-ERCP severe acute pancreatitis (SAP) accompanied with duodenum perforation is rare but serious, remaining a challenge in clinic. In this study we report two such cases. Two Chinese women were treated for clinical suspicion of bile duct obstruction and underwent ERCP after admission. Both developed duodenum perforation and SAP after ERCP, and were managed in the intensive care unit (ICU) and required an organ-failure support. The surgical intervention of the peri-pancreatic debridement with lumber-abdominal compound incisions and postoperative washing and drainage was performed, and the two patients recovered well. The therapeutic effect of the peri-pancreatic debridement with lumber-abdominal compound incisions combined with postoperative washing and drainage in the patients of severe post-ERCP-pancreatitis (PEP) and duodenum perforation is satisfactory.Endoscopic retrograde cholangiopancreatography （ERCP） is a procedure widely used to diagnose and treat conditions of biliary or pancreatic ductal system. The post-ERCP severe acute pancreatitis （SAP） accompanied with duodenum perforation is rare but serious, remaining a challenge in clinic. In this study we report two such cases. Two Chinese women were treated for clinical suspicion of bile duct obstruction and underwent ERCP after admission. Both developed duodenum perforation and SAP after ERCP, and were managed in the intensive care unit （ICU） and required an organ-failure support. The surgical intervention of the peri-pancreatic debridement with lumber-abdominal compound incisions and postoperative washing and drainage was performed, and the two patients recovered well. The therapeutic effect of the peri-pancreatic debridement with lumber-abdominal compound incisions combined with postoperative washing and drainage in the patients of severe post-ERCP-pancreatitis （PEP） and duodenum perfora- tion is satisfactory.

关 键 词：Endoscopic retrograde cholangiopancreatography （ERCP） Post-ERCP-pancreatitis （PEP） Duodenum perforation DEBRIDEMENT Drainage 

分 类 号：TS411[农业科学—烟草工业] S858.28