急性胆源性胰腺炎的内镜下介入治疗

Endoscopic Interventional Therapy for Patients with Acute Biliary Pancreatitis

目的 :综合评价早期内镜下介入治疗急性胆源性胰腺炎的方法、疗效及并发症等。方法 :10 3例胆源性胰腺炎患者中 ,5 7例在 72h内行早期内镜下介入治疗 ,4 3例保守治疗 ,保守治疗中的 19例择期内镜检查及治疗 ,3例外科手术治疗。结果 :早期内镜治疗组 80 .70 %患者临床症状得到迅速缓解 ;保守治疗组 6 2 .79%也可迅速缓解。全部内镜治疗后 3例出现胰腺炎加重。结论 :早期内镜介入治疗对于急性胆源性胰腺炎是一种有效而安全的方法 ,对于有明显黄疸、感染、结石嵌顿的病例应急诊内镜下治疗 ;对于病情较轻。

Objective: To investigate the method, value and complication of endoscopic therapy of acute biliary pancreatitis. Methods: Early endoscopic therapy was performed within 72 hours in 57 patients among 103 cases of acute biliary pancreatitis. 43 patients received conservative management. 19 of the conservative management group received selective endoscopic therapy, and 3 underwent surgical operation. Results: The clinical symptoms of 80.70% patients improved quickly in early endoscopic therapy group and 62.79% of conservative management group. 3 cases developed pancreatitis exacerbation after endoscopic treatment. Conclusions: Early endoscopic therapy is an effective and safe method for those with severe jaundice, bile duct infection and/or biliary colic. Elective ERCP/EST is indicated for patients with mild disease course and slight jaundice after conventional treatment.