急性胆源性胰腺炎的手术治疗

Surgical treatment of acute biliary pancreatitis

目的探讨急性胆源性胰腺炎(ABP)的手术时机和手术治疗方式。方法回顾分析112例ABP的临床资料。结果23例急诊手术,分别进行了内镜下Oddi括约肌切开取石+腹腔镜胆囊切除术、胆道探查+胰腺包膜切开引流,发生并发症5例,死亡2例。89例延期手术,分别进行了腹腔镜胆囊切除术、开腹胆囊切除术、胆囊切除术+胆总管探查、胆囊切除+胆总管探查+左肝外叶切除、胆囊切除+胰腺假性囊肿内引流术,未发生严重并发症。结论ABP首选非手术治疗,延期手术较急症手术有更大的安全性。

Objective To investigate the the timing of operation and surgical treatment of ABP.Methods The clinical data of 112 cases of ABP were retrospectively analyzed.Results 23 patients underwent emergency operation,they received endoscopic sphincterotomy（EST）＋laparoscopic cholecystectomy,exploration of common bile duct＋ capsula pancreatis incision and drainage,5 cases had complications and 4 cases died.89 patients underwent delayed operation,they received laparoscopic cholecystectomy（LC）,open cholecystectomy,cholecystectomy＋ exploration of common bile duct,cholecystectomy＋ exploration of common bile duct＋hepatectomy for left lateral,cholecystectomy＋pancreatic pseudocyst internal drainage and no severe complications were observed.Conclusion Non-surgical treatment is the first choice for ABP,Delayed surgery operation has greater security than emergency operation.