内镜介入治疗在急性胆源性胰腺炎中的应用

Analysis of endoscopic therapy for cholecystolithiasis complicated with acute biliary pancreatitis

目的评价早期行内镜逆行胰胆管造影(ERCP)及介入治疗对急性胆源性胰腺炎患者的安全性和临床疗效。方法将96例急性胆源性胰腺炎住院患者分为A、B两组,A组行ERCP检查和治疗,B组行内科保守治疗,分别观察其疗效和并发症,评价急性胆源性胰腺炎患者内镜治疗的安全性和疗效。结果A组患者治愈率98%,无严重并发症发生,未见因ERCP检查和治疗而使病情加重者,其腹痛缓解时间、住院天数、血淀粉酶恢复时间明显短于B组。结论早期内镜介入治疗急性胆源性胰腺炎具有微创、安全、有效、快速解除胆道急性梗阻及防止胆汁胰管反流的特点,可使急性胆源性胰腺炎患者得到快速及时的诊治,防止病情进一步发展。

Objective To evaluate the safety and effect of early therapeutic endoscopic retrograde cholangiopancreatography （ERCP） for patients with acute biliary pancreatitis. Methods Ninety -six cases of acute biliary pancreatitis who were divided into A and B groups were treated with early therapeutic ERCP and internal medical therapy differently. The effect, complications and safety were evaluated. Results The symptoms and signs in 98% cases of group A after ERCP disappeared faster than those of group B. There was no ERCP related severe complication or aggrevated symptom. Conelusion Early therapeutic ERCP is micro- invasive and highly effective in relieving pancreaticobiliary obstruction safely, and may play an important role in the early treatment of acute biliary pancreatitis and can prevent further progression to severe status.