经内镜治疗急性胆源性胰腺炎24例报告

Case Report of Endoscope Treatment of Acute Biliary Pancreatitis

目的探讨急性胆源性胰腺炎内镜联合治疗及其治疗效果。方法对急性胆源性胰腺炎首先行内镜下乳头括约肌切开取石 (EST) ,同时置入鼻胆管引流 (ENBD) ;合并胆囊结石者 ,待胰腺炎恢复后 ,施行腹腔镜胆囊切除术 (LC)。结果全组24例中 ,19例胆管结石行EST取出 ,所有病人均行ENBD ;胰腺炎顺利治愈23例 ,治愈率95.5 % ;合并胆囊结石19例 ,恢复期行LC ,17例顺利切除胆囊 ,2例中转开腹。结论EST+ENBD能有效治疗急性胆源性胰腺炎 ,伴胆囊结石者联合应用LC ,使微创手术的优点在该病整个疗程中得以体现 。

Objective To explore the therapeutic efficacy of the combined endoscope treatment of the acute biliary pancreatitis. Methods Endoscope sphincterotomy (EST) was conducted in the acute biliary pancreatitis together with endoscope nasobiliary drainage (ENBD). Laparoscopic cholecystomy (LC) was carried out in the cases with cholelithiasis. Results Out of 24 cases, 19 cases were underwent EST to remove the stone. ENBD was carried out in all the cases. 23 pancreatitis cases were cured with the effective rate of 95.5%. 19 cases were complicated with cholelithiasis and LC was conducted in the recovery stage. Conclusion EST and ENBD were effective in the treatment of the acute biliary pancreatitits. LC should be carried out in the cases with cholelithiasis so as to reduce the operative trauma.