急性胆源性胰腺炎的微创外科治疗

INVESTIGATION OF MINIMAL INVASIVE PROCEDURES FOR TREATMENT OF ACUTE BILIARY PANCREATITIS

目的探讨腹腔镜及十二指肠镜等微创技术在治疗急性胆源性胰腺炎的可行性和有效性。方法回顾性分析2001年3月～2006年4月我院单独用腹腔镜或十二指肠镜以及两镜连用治疗156例急性胆源性胰腺炎的临床资料。结果早期有2例中转开腹，其余患者均在腹腔镜或十二指肠镜下成功完成手术，全部治愈。结论对无梗阻的急性胆源性胰腺炎患者早期采用保守治疗，2～4周后行腹腔镜胆囊切除术，疗效好，并发症少，微创，值得推广。而对有胆道梗阻的ABP应早期先行内镜下治疗，2～3周后择期行LC，这样可避免发生严重并发症，减少水肿性胰腺炎发展为重症胰腺炎，可预防ABP复发。

Objective To explore the feasibility and efficacy of minimal invasive procedures （laparoscopic or/and endoscopic techniques） in the treatment of acute biliary pancreatitis. Method 156 cases of acute biliary pancreatitis of our hospital during March, 2001 to April, 2006 were analyzed retrospectively. Laparoscopic or/and endoscopic procedures were performed individually for all the cases. Result 2 of the cases were converted to open operation, the others were performed laparoscopic or/and endoscopic procedures successfully. All the cases were cured. Conclusion For the patient of acute biliary pancreatitis with no obstruction, expectant treatment in early stage, followed with laparoscopic cholecystectomy 2 to 4 weeks later, results in less complications, better therapeutic effects. And for the patient of acute biliary pancreatitis with obstruction, endoscopic therapy in early stage, followed with laparoscopic cholecystectomy, could avoid severe complications, prevent edematous pancreatitis turn into severe pancreatitis, and relapse of ABP.