急性胰腺炎并发胆道系统疾病的诊治进展  

Progress in the diagnosis and treatment of acute pancreatitis complicated by biliary tract diseases

作　　者：李启元 罗岩 孙备[1] Li Qiyuan;Luo Yan;Sun Bei(Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院胰胆外科,哈尔滨150001

出　　处：《中华外科杂志》2025年第1期76-80,共5页Chinese Journal of Surgery

基　　金：国家自然科学基金(81871974、82070658)。

摘　　要：急性胰腺炎是外科常见的急腹症,其发展过程中往往伴随着严重的局部或全身并发症。胆道系统疾病是急性胰腺炎严重的局部并发症之一,主要包括急性非结石性胆囊炎和胆管狭窄。急性非结石性胆囊炎常发生在急性胰腺炎的病程后期,会加重患者全身炎症反应,严重时可导致器官功能衰竭等,危及生命。胆管狭窄是急性胰腺炎少见的远期严重并发症,可诱发胆管炎、进行性肝功能损害和继发性胆汁性肝硬化等严重并发症。由于急性胰腺炎的临床症状可掩盖其他症状,部分发病期间并发胆道系统疾病的患者未能得到及时诊治,严重时可危及患者生命。目前,针对急性胰腺炎继发胆道系统并发症的理想治疗策略尚不明确,缺乏具有指导意义的指南或共识。本文结合近年来国内外相关研究进展,对急性胰腺炎并发胆道系统疾病的发病机制、诊断及治疗策略进行阐述。Acute pancreatitis is a common surgical emergency characterized by severe local or systemic complications during its progression.Diseases of the biliary system are among the serious local complications of acute pancreatitis,primarily including acute acalculous cholecystitis(AAC)and biliary stricture.AAC often occurs in the later stages of acute pancreatitis,exacerbating systemic inflammation and leading to organ failure and life-threatening conditions in severe cases.Biliary stricture is a rare but serious long-term complication of acute pancreatitis,which can induce cholangitis,progressive liver function impairment,and secondary biliary cirrhosis.Due to the clinical symptoms of acute pancreatitis that can mask biliary system diseases,some patients may not receive timely diagnosis and treatment for concurrent biliary issues during the onset of acute pancreatitis,which can be life-threatening in severe cases.Currently,the ideal treatment strategy for biliary system complications secondary to acute pancreatitis remains unclear,lacking definitive guidelines or consensus.This article integrates recent research developments from both domestic and international studies to elucidate the pathogenesis,diagnosis,and treatment strategies for biliary system complications secondary to acute pancreatitis.

关 键 词：胰腺炎 胆道疾病 急性非结石性胆囊炎 胆管狭窄 

分 类 号：R65[医药卫生—外科学]