胆源性胰腺炎胆系结石处理的时机与方式

Timing and management of biliary calculi in biliary pancreatitis

急性胆源性胰腺炎(ABP)占我国急性胰腺炎发病总数的50%以上,多数ABP病人为轻症,可在住院时同期行胆囊切除术,以预防ABP复发。而对于中、重症ABP病人应避免早期手术,待病情稳定后择期行手术治疗。对于早期伴有持续性胆道梗阻的ABP病人,无论是否合并急性胆管炎,均应早期内行内镜治疗以解除梗阻,通畅引流。总之,对于ABP病人胆系结石的处理,无论是内镜还是手术治疗,均应在国内外指南的建议下,结合病人的具体情况,制定个体化治疗方案,使病人获得最佳的治疗。

Acute biliary pancreatitis accounts for more than50%of the total incidence of acute pancreatitis in China.Most ABP patients are mild,and cholecystectomy can be performed at the same time of hospitalization to prevent recurrence of ABP.However,for patients with moderate or severe ABP,early operation should be avoided,and surgical treatment should be performed after the condition stabilizes.For ABP patients with persistent biliary obstruction,endoscopic therapy should be performed in the early stage.In brief,for ABP patients,whether endoscopic treatment or surgical treatment,the timing and method of the treatment of biliary calculi should be based on the recommendations of domestic and foreign guidelines,and individualized treatment plans according to the specific conditions of the patients,so that the patients can get the best treatment.