内镜下乳头括约肌切开对预防急性胆源性胰腺炎复发的临床价值

Clinical Implication of EST for Preventing the Recurrence of Acute Gallstone Pancreatitis

目的 探讨内镜下乳头括约肌切开 (endoscopicsphincterotomy ,EST)对预防急性胆源性胰腺炎 (gallstonepan creatitis ,GP)复发的临床价值。 方法 184例急性GP患者中 ,随机分为EST治疗组 ( 77例 )和非EST对照组 ( 10 7例 )。每组患者进一步分为胆囊切除组和非胆囊切除组。随访所有急性GP患者 ,比较二组复发率有无显著差异。结果 二组患者平均随访时间 ( 2 6± 11)个月 ;5例失访 ,随访率 97%。EST治疗组 ( 3 74)的复发率明显低于非EST治疗组 ( 4 4 10 5 ) ,其差异有显著性 (P <0 .0 1) ;而胆囊切除虽然能降低急性GP的复发率 ,但其差异无显著性 (P >0 .0 5 )。 结论 应用EST技术治疗急性GP ,可预防其再次发作。

Objective To explore the clinical value of EST in prevention the recurrence of acute gallstone pancreatitis (GP). Methods 184 patients of acute GP were divided into EST treatment group (n=77) and non-EST control group (n=107) at random. Each group was further divided into cholecystectomy group and non- cholecystectomy group. Follow-up visits were paid to all the patients and comparisons were made to see whether the recurrence rate of the cases between the two groups had any significant importance. Results 179 out of the cases got followed up for average 26±11months(97%).The recurrence rate in the EST group (3/74) were significantly lower than that in the patients of non-EST control (44/105),(P<0.01). Further comparision showed that cholecystectomy could not significantly, reduce the recurrence rate of acute GP(P>0.05). Conclusion The application of EST in the patients of acute GP can prevent its recurrence.