老年人重症胆源性胰腺炎的治疗体会

Treatment Experience of Senile Severe Bilious Pancreatitis

目的探讨老年胆源性胰腺炎的临床特点及治疗经验。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、胆囊管引流。结果12例术后预期治愈;1例合并应激化溃疡,经保守治疗痊愈,1例发生肠腔积液,抗感染治疗后满意;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 experience of senile severe bilious pancreatitis. Methods 18 cases of such patient were underwent the operation （ among them 16 cases within 24 h and 2 cases within 72 h）. All cases were cholecystectomy and bile duct drainage. Results 12 case cure after operation. 1 case suffered ulcer after operation and 1 case enteric fluid and finally healed. 2 cases died of MOF and pancreas necrosis. Condusion The operation procedure must be simple and effective for such patient to perform the choleccystectomy and solve the obstruction of bile duct.