急性胆源性胰腺炎的外科处理

Surgical Treatment of Acute Biliary Pancreatitis

目的:探讨急性胆源性胰腺炎(ABP)的发病机制、外科处理方式及预后。方法:回顾性分析我院2004年6月至2009年6月收治的126例ABP的临床资料。结果:入院时梗阻性ABP 39例,非梗阻性ABP87例;轻型81例,重型45例。早期手术29例中发生并发症12例(41.4%),死亡7例;延期手术97例中发生并发症5例(5.2%),死亡1例。结论:外科手术在胆源性胰腺炎治疗中具有重要地位,以胆道梗阻为主的ABP应急诊解除梗阻,胆道无梗阻先采用非手术治疗,待胰腺炎控制后,再处理胆道病变。

Objective：To investigate the pathogenic mechanism, operative treatment and prognosis of acute biliary pancreatitis （ABP）. Methods： The clinical data of 126 patients with ABP from Jun 2004 to Sep 2009 were analyzed retrospectively.Results：39 were obstructive type and 87 were non-obstructive type. 81 were categorized as mild and 45 as severe. 12 cases （41.4%）occured complications and 7 died among 29 cases operated early, 5 occured （5.2%） complications and 1 died among 97 cases operated delay. Conclusion： Surgical operation plays an important role in the treatment of ABP. The biliary obstruction predominant ABP should be treated on the obstruction as priority whereas the non-obstruction type should be treated conservatively first to control the imflammation in pancreas before the biliary problems getting treated.