急性胆源性胰腺炎的微创治疗
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龙锦

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Minimally invasive treatment for acute biliary pancreatitis
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    摘要:

    目的: 探讨应用十二指肠镜及腹腔镜治疗急性胆源性胰腺炎(ABP)的有效性。
    方法:回顾性分析5年间对94例ABP患者进行微创治疗的临床资料。ABP合并胆囊结石的59例行行单纯腹腔镜胆囊切除术(LC);胆总管结石14例内镜下乳头括约肌切开取石术(EST),同时置入鼻胆管引流(ENBD),其中3例联合LC;对胆囊结石合并胆总管结石21例行ERCP + EST,联合LC治疗。
    结果:全组术后再次发作胰腺炎1例,胆道出血1例,均为ERCP+EST患者;另肺部感染2例,切口感染1例,5例均经非手术治疗痊愈。全组有效率100%。
    结论:十二指肠镜及腹腔镜联合应用于治疗ABP效果好。微创技术是目前ABP理想的治疗方法。

    Abstract:

    Abstract:Objective:To discuss clinical effects of combined use of duodenoscopy and laparoscopy in the treatment of acute billiary pancreatitis (ABP).
    Methods :The clinical data of 94 ABP patients who underwent minimally invasive treatment from February 2001 to Feburary 2006 were retrospectively reviewed. Among 94 ABP patients, 59 patients had gallbladder stones were given laparoscopic cholecystectomy (LC) alone; 14 patients had common bile duct stones received endoscopic nasobiliary drainage (ENBD), combined endoscopic sphincterotomy (EST) and LC; 21 patients had both gallbladder and common bile duct stones received combined EST and LC.
    Results:Postoperatively, in the whole group, only one patient had recurrent pancreatitis, one patient had hemobilia,and both cases followed ERCP+EST; two cases had lung infection,and one case had infection of abdominal incision. All of the 5 cases with postoperative compllcations were successfully treated by conservative therapy. The effective rate for the whole group was 100%.
    Conclusions:Combined use of duodenoscopy and laparoscopy is significantly effective for treatment of acute biliary pancreatitis and this minimally invasive treatment is the ideal therapy for acute biliary pancreatitis.

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龙锦,何忠野,葛春林,郭仁宣,郭克建.急性胆源性胰腺炎的微创治疗[J].中国普通外科杂志,2007,16(5):1-.
DOI:10.7659/j. issn.1005-6947.2007.05.001

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  • 在线发布日期: 2007-05-25