梗阻型急性胆源性胰腺炎的治疗方式及手术时机的选择  

Management and opportunity of operation in obstructive acute biliary pancreatitis

作　　者：汤达承[1] 乔安意[1] 杨星[1] 胡扬喜[1] 王翀[1] 杨晟[1] 

机构地区：[1]广州医学院第三附属医院肝胆外科,广州510150

出　　处：《国际外科学杂志》2011年第6期372-375,共4页International Journal of Surgery

摘　　要：目的探讨梗阻型急性胆源性胰腺炎的治疗方式及手术时机的选择。方法回顾分析广州医学院第三附属医院2000年至2010年76例梗阻型急性胆源性胰腺炎的临床资料。结果全组手术治疗36例，两周内手术20例，延期手术16例，死亡1例，术后随访无复发。内镜治疗15例，其中ERCP／EST11例，ERCP／ENBD1例，ERCP3例，均获痊愈，随访1例复发。非手术治疗25例，死亡1例，随访6例复发。结论外科手术在胆源性胰腺炎治疗中具有重要地位。对梗阻型急性胆源性胰腺炎患者应在经短期积极的非手术治疗后早期手术或内镜治疗解除胆道梗阻。Objective To investigate the management and timing of operation in obstructive acute biliary pancreatitis. Methods A retrospective review was performed of seventy-six consecutive patients who presented to a single tertiary care institution from 2000 to 2010 with obstructive acute biliary pancreatitis. Results Of the seventy-six patients,thirty-six patients underwent operations, with early （after onset within 2 weeks）operations in twenty cases, delayed operationsin sixteen cases and one case dead, no one experienced recurrent pancreatitis during follow-up. Fifteen patients were treated by endoscopy, ERCP/EST in eleven cases,ERCP/ENBD in one case and ERCP only in three case. All patients were cured, only one patient experienced recurrent pancreatitis. Twenty-five patients received conservative treatment, one patient died, six patients experienced recurrent pancreatitis. Conclusions Surgery is essential in the management of acute biliary pancreatitis. In cases of obstructive acute biliary pancreatitis, early operation or endoscopic therapy should be performed to remove hiliopancreatic obstruction after aggressive conservative treatment.

关 键 词：急性胆源性胰腺炎 内镜治疗 手术时机 胆囊切除术 

分 类 号：R657.51[医药卫生—外科学]