老年重症胆源性胰腺炎的治疗体会

Treatment Experience of Senile Severe Biliary Pancreatitis

目的探讨老年胆源性胰腺炎的临床特点及治疗。方法观察老年胆源性胰腺炎18例,全部病例均采用手术治疗,其中24 h内手术者16例,72 h内手术2例,全部病例均行胆囊切除,胆总管引流。结果12例术后预期治愈;1例合并应激性溃疡,经保守治疗痊愈,1例发生胸腔积液,抗感染治疗后痊愈;2例死亡,1例死于多脏器脏功能衰竭,1例死于胰腺坏死,继发感染。结论老年胆源性胰腺炎,手术方式尽量从简,以切除病变胆囊,解除梗阻为主,注重并发症的治疗。

Objective To discuss the clinical characteristics and treatment of senile severe biliary pancreatitis. Methods 18 cases of such patient were performed operation, 16 cases were operated within 24h and 2 cases were operated within 72 h. All cases were performed with bile bladder resection and drainage of bile duct. Results 12 cases were healed. 1 case was combined with stress ulcer with conservation therapy. 1 case had hydrothorax and healed after anti - infection. 2 cases were dead 1 case dead from MOF and another pancreas necrosis with infection. Conclusion The operation should be as simple as possible for bile bladder resection and obstruction released with prevention of complication.