腹腔镜手术在急性胆源性胰腺炎EST失败后的应用  

Laparoscopic cholecystectomy and laparoscopic common bile duct exploration in the treatment of acute biliary pancreatitis after failure of endoscopic sphincterotomy

作　　者：魏晓平[1] 胡明道[1] 杨万雄 李伟[1] 周健 田大广[1] 

机构地区：[1]昆明医科大学第二附属医院肝胆胰一病区,云南省昆明市650101 [2]云南保山市施甸县医院普通外科,云南省保山市678200 [3]云南保山市中医院肝胆外科,云南省保山市678000

出　　处：《世界华人消化杂志》2014年第15期2190-2193,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨急性胆源性胰腺炎(acute biliary pancreatitis,ABP)经内镜乳头括约肌切开术(endoscopic sphincterotomy,EST)治疗失败后,急诊行腹腔镜手术的疗效.方法:回顾分析13例ABP患者EST治疗失败后结合液电碎石及超声刀行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合胆道探查术(laparoscopic common bile duct exploration,LCBDE)临床资料,记录手术时间、出血量、住院时间及术后并发症发生率.结果:手术均获成功,无1例中转开腹.手术时间95-163 min,住院时间10-14 d,1例(7.7%)发生胆管残余结石.结论:针对ABP行EST失败后病例,LC+LC-BDE是一种安全有效的治疗方法.AIM： To evaluate the efficacy of laparoscopic cholecystectomy （LC） and laparoscopic common bile duct exploration （LCBDE） in the treatment of acute biliary pancreatitis （.ABP） after failure of endoscopic sphincterotomy （EST）. METHODS： Thirteen patients who were diagnosed with ABP after failure of EST were treated with LC plus LCBDE in which electrohydrauliclithotripsy and harmonic scalpel were used. The hospital stay, operation time, loss of blood and postoperative complications were recorded. RESULTS： The procedure was successful in all the patients. The operation time and hospital stay were 95-163 min and 10-14 d, respectively. One of the patients had residual stones （7.7%）. CONCLUSION： LC combined with LCBDE is an effective and safe way to treat ABP after failure of EST.

关 键 词：腹腔镜 胰腺炎 经内镜乳头括约肌切开术 

分 类 号：R657.4[医药卫生—外科学]