外科治疗急性胆源性胰腺炎

Surgical treatment of acute biliary pancreatitis

目的探讨急性胆源性胰腺炎(ABP)手术时机和术式的选择。方法回顾性分析2 4 7例急性胆源性胰腺炎的临床资料。结果非手术治疗1 0例,死亡4例;1 2例急诊手术后发生并发症5例,死亡2例;1 6 9例延期手术术后发生并发症1例,治愈;5 6例择期手术无并发症发生。结论以胆道梗阻为主的ABP应急诊手术解除胆道梗阻;胆道无梗阻先采用非手术治疗,胰腺炎控制后,再处理胆道病变。

Objective To investigate the timing of operation and the selection of surgical procedure for acute biliary pancreatitis. Methods The clinical data of 247 cases of acute biliary pancreatitis were retrospectively analysed. Results Among 10 non-operation patients, 4 died ; 12 patients underwent emergency operation, 5 had postoperative complications and 2 patients died after operation. 169 patients underwent delayed operation after effective conservative therapy and 1 patient had postoperative complication; 56 patients underwent selective operation without any postoperative complication or death. Conclusions Early emergency operation should be performed for relief of biliary obstruction in acute biliary obstructive pancreatitis. The patients with acute non-obstructive biliary pancreatitis should undergo conservative therapy at first and then, after pancreatitis has been controlled, delayed operation or selective operation to treat the biliary pathologic condition should be performed.