急性胆石性胰腺炎手术时机的选择

THE TIMING OF THE OPERATION FOR ACUTE GALLSTONE PANCREATITIS

目的探讨急性胆石性胰腺炎（ＡＧＰ）的病因、治疗方案及手术方式。②方法回顾性分析４８例行手术治疗的胆石性胰腺炎病人的临床资料和治疗结果。③结果微小结石在壶腹部的滑动是胰腺炎发作的重要病因之一。４８例ＡＧＰ中，水肿型胰腺炎３６例，出血坏死型胰腺炎１２例。早期手术１２例，死亡２例（６．６％）；早期非手术治疗３６例，１例死于多脏器功能衰竭（２．７％）；３５例痊愈，其中２９例在胰腺炎痊愈后９０～１８０ｄ内择期行胆道手术，无１例死亡。④结论ＡＧＰ治疗宜采取个体化治疗方案。

Objective\ To evaluate the causes of acute gallstone pancreatitis (AGP), therapeutic regimen and operative pattern.\ Methods\ The clinical data and therapeutic outcomes of 48 cases during the past 5 years were reviewed.\ Results\ The movement of the small stone in ampulla of vater was one of the important causes which lead to pancreatitis. Of 48 cases with AGP, there were 36 cases with acute edematous pancreatitis and 12 cases with acute necrotic pancreatitis. 12 patients were operated at the early stage and 2 of them died. 36 patients were treated by conservative therapy at the early stage, 1 died of MOF and 35 recovered. Within 90-180 days after recovery, 29 patients accepted the time selected operation.\ Conclusion\ Individual management can be applied to the treatment of AGP.