急性胆源性胰腺炎手术时机与方法的探讨

Investigation on Surgical Timing and mode in Patients with Acute Gallstone Pancreatitis

目的 :探讨急性胆源性胰腺炎 (AGP)的手术时机与方法。方法 :对 83例急性胆源性胰腺炎据其是否存在胆道梗阻及轻重分型分为四组进行分析。结果 :轻型非梗阻型AGP 3 7例及轻型梗阻型AGP 15例均治愈 ;重型非梗阻型AGP 11例治愈 10例 ,死亡 1例 ;重型梗阻型AGP 2 0例治愈 17例 ,死亡 3例。结论 :急性胆源性胰腺炎应根据其具体分型制定个体化治疗方案 ,非梗阻型尽量保守治疗 ,梗阻型如不能自行缓解则早期手术。保守成功者于出院前行胆道手术 ,同时处理胰腺并发症。

Objective:To investigate the timing and mode of surgical management in patients with acute gallstone pancreatitis(AGP).Methods:83 patients with AGP admitted and treated in our hospital were analyzed retrospectively. The patients were divided into four groups based on whether mild or severe and with or without bile duct obstruction.Results:52 mild patients were all cured. 10 paients of severe AGP without bile duct obstruction were cured,1 of them died. 17 patients of severe AGP with bile duct obstruction were cured,3 of them died.Conclusions:The patients with AGP should be treated based on which type they are. Conservative treatments are recommended to the patients without bile duct obstruction. The patients with bile duct obstruction should be treated with early operation if bile duct obstruction could not relieve automatically. The patients treated with conservative treatment successfully should be treated with delayed bile operation during the same hospital stay. Pancreatic complications shoud be treated simultaneously. The principles of early operation are stones extraction and efficient in drainage.