非结石性胆源性急性胰腺炎的病因及手术时机的探讨  

A study on the etiology of and timing for operation of acalculous biliary acute pancreatitis

作　　者：王选[1] 武世荣[1] 陈文亮[1] 高峰[1] 张伟林[1] 

机构地区：[1]山西医科大学第二医院普通外科,太原030001

出　　处：《中华普通外科杂志》2003年第1期18-19,共2页Chinese Journal of General Surgery

摘　　要：目的　探讨非结石性胆源性急性胰腺炎的病因及手术时机。方法　总结 38例非结石性胆源性急性胰腺炎的发病原因及治疗经验。结果　本组共行手术 13例 ,早期手术 6例 ,术后无并发症及死亡 ;中期重型急性胰腺炎手术 5例 ,1例合并胰瘘 ,1例合并高位小肠瘘死亡 ;晚期手术2例 ,1例死亡。本组手术死亡率为 15 % (2 /13)。非手术治疗重型胰腺炎 4例 ,早期死亡 1例。轻型胰腺炎 2 1例均经非手术治疗痊愈。结论　非结石性胆源性急性胰腺炎合并存在胆道感染时应早期手术 ,否则应先试行积极的支持治疗。Objective To explore the etiology of and timing for operation of acalculous biliary acute pancreatitis(ABAP).MethodsWe retrospectively analyzed the etiology study and treatment experience of 38 cases of ABAP.ResultsThirteen cases underwent a surgery, including 6 early operations for complicated biliary tract infection without morbidity and mortality, 5 middle staged patients (5～14 days after onset of ABAP) underwent surgery because of intraabdominal indications with one postoperative death and 2 late operations for severe acute pancreatitis (SAP) resulted in one postoperative death of sepsis. The total postoperative mortality rate was 15%( 2/13). Four SAP cases were managed conservatively with one death of MOF. The remaining 21 cases of acute edematous pancreatitis (AEP) were cured by nonoperative methods.ConclusionWhereas an early exploration is indicated, when complicated by biliary tract infections, it is judicious to try a conservative therapy first for ABAP patients.

关 键 词：非结石性胆源性急性胰腺炎 病因 外科手术 手术时机 

分 类 号：R657.51[医药卫生—外科学]