急性胆源性胰腺炎的内镜治疗  

Endoscopic treatment of acute biliary pancreatitis

作　　者：吴海雄[1] 郑锦锋[1] 张卓[1] 

机构地区：[1]暨南大学医学院第二附属医院肝胆外科,广东省深圳市518020

出　　处：《河北医药》2004年第3期233-234,共2页Hebei Medical Journal

摘　　要：目的　探讨急性胆源性胰腺炎 (acutebiliarypancreatitis ,ABP)的内镜治疗。方法　对我院1998年 3月至 2 0 0 3年 3月收治的急性胆源性胰腺炎 92例首先行内镜下乳头括约肌切开取石 (EST) ,同时置入鼻胆管引流 (ENBD) ;合并胆囊结石者 ,待胰腺炎恢复后 ,施行腹腔胆囊切除术 (LC)。结果　全组92例中 ,5 3例胆管结石行EST取出 ,所有病人均行ENBD ;胰腺炎顺利治愈 88例 ,治愈率 95 .6% ;合并胆囊结石 67例 ,恢复期行LC ,均顺利切除胆囊治愈 ;经非手术治愈 2 3例占 2 5 % ;行腹腔镜探查手术 69例占 75 %。结论　EST +ENBD能有效治疗急性胆源性胰腺炎 ,伴胆囊结石者联合应用LC ,是目前理想的治疗方法。Objective To observe the therapeutic effect of endoscope on acute biliary pancreatitis.Methods 92 patients with acute biliary pancreatitis,admitted into our hospital from March 1998 to March 2003,were treated by endoscopic sphincterotomy combined with endoscopic nasobiliary drainage (ENBD).The patients who were complicated by cholelithiasis were treated by laparoscopic cholecystectomy (LG) after recovery of pancreatitis.Results Among 92 patients 53 cases underwent EST to remove the stone.ENBD was performed in all the cases.88 patients with pancreatitis were cured with the effective rate of 95.6%.The 67 cases complicated by cholelithiasis were cured by LG during recovery period.23 cases (25%) were cured by non-surgical treatment and 69 cases (75%) underwent laparoscopic exploration.Conclusion EST combined with ENDB is effective in treating acute biliary pancreatitis.LG is an ideal therapy for the patients complicated by cholelithiasis.

关 键 词：急性胆源性胰腺炎 内镜 乳头括约肌切开取石术 鼻胆管引流术 腹腔胆囊切除术 

分 类 号：R657.51[医药卫生—外科学]