十二指肠镜联合腹腔镜治疗急性胆源性胰腺炎的临床价值

Clinical value of duodenoscopy combined with laparoscopy in treating acute biliary pancreatitis

目的探讨十二指肠镜联合腹腔镜治疗急性胆源性胰腺炎(ABP)的治疗方法和临床效果。方法我院于2000年2月～2007年10月前后以两种不同的方式治疗ABP84例,前期35例(对照组)予保守和/或开腹手术治疗,后期49例(治疗组)行ERCP、ENBD、EST和腹腔镜手术,比较两者的疗效。结果全组病例均治愈。治疗组21例无胆道梗阻的ABP保守治疗1周行LC,28例有胆道梗阻的ABP急诊行ERCP、ENBD或EST,3周后再行腹腔镜手术。治疗组与对照组比较,体温、生化指标、血淀粉酶等恢复时间及住院时间短,住院费用低(P<0.05)。结论十二指肠镜和腹腔镜的联合应用是治疗ABP安全有效的方法。

[Objective] To explore the therapeutics and clinical curative effects of duodenoscopy combined with laparoscopy in treating acute biliary pancreatitis （ABP）. [Methods] From February 2000 to October 2007, 84 ABP patients in our hospital were divided into two groups according to different therapeutics in the prophase and later period： 35 cases in control group received conservative therapy and/or open surgery in the early days; 49 cases in experimental group received duodenoscopy such as ERCP, ENBD, EST and laparoscopic surgery in the later period. The curative effect in the two groups was subsequently compared. [Results] All the patients were cured. In experi- mental group, 21 cases without obstruction of biliary tract underwent LC after a week of conservative treatment; 28 cases underwent urgently ERCP, EST, ENBD before treated with LC or LCDE 3 weeks later. Compared with control group, experimental group possessed shorter recovery time of body temperature,biochemical indicators and hemodias- tase and length of stay and lower cost of hospitalization （P 〈0.05）. [Conclusion] Duodenoscopy combined with laparoscopic surgery is a safe and effective method in treating acute biliary pancreatitis （ABP）.