急性胆源性胰腺炎的早期内镜介入治疗

Intervention Treatment of Early Internal Microscope to Acute Billary Pancreatitis (ABP)

[目的]探讨急性胆源性胰腺炎早期内镜治疗的方法及疗效。[方法]对急性胆源性胰腺炎64例,入院24～72h先行逆行胰胆管造影(ERCP)。对明确有胆总管结石、狭窄等病例行乳头括约肌切开术(EST)及内镜鼻胆引流术(ENBD)和内镜逆行胆管引流术(ERBD)等治疗,合并胆囊结石者,待胰腺炎恢复后,施行腹腔镜胆囊切除术(LC)。[结果]64例中,20例胆总管结石行EST取出,行ENBD7例,胰腺炎顺利治愈62例,治愈率96.9%;合并胆囊结石42例,恢复期行LC,均顺利切除胆囊治愈,非手术治愈14例占21.9%。[结论]EST+ENBD能有效治疗急性胆源性胰腺炎,合并胆囊结石者联合应用LC,是目前理想的治疗方法。

[Objective] To explore the method and effect on ABP.[Method] Select 64 cases and make ERCP to them within 24-72 hours,make EST,ENBD and ERBD to whom with choledocholithiasis and narrowness, LC to whom with cholelithiasis after parereatitis was relieved, [Result]20 cases were taken out EST, 7 ENBD, 62 were cured smoothly, cure rate 96.9 -42 cases with cholelithiasis were cured with successful dissection of bile-cyst, 14 curd with non-operation,occupying 21.9%. [Conclusion] EST＋ENBD is an ideal method for ABP,applying LC to those with cholelithiasis.