内镜对急性胆源性胰腺炎的病因诊断及治疗

The Pathogenic Diagnosis and the Treatment of Acute Biliary Pancreatitis by Endoscopy

目的 探讨内镜对急性胆源性胰腺炎 (ABP)的病因诊断及治疗作用。方法 分析我院急诊内镜诊疗ABP18例 ,观察其效果及并发症。结果 18例ABP病因分别为胆管结石 12例 ,胆管结石 +胆囊结石 1例 ,胆道蛔虫 1例 ,十二指肠乳头炎 2例 ,壶腹癌 1例 ,Oddi氏括约肌功能紊乱 1例。内镜逆行胰胆管造影 (ERCP)对ABP的病因诊断明显优于B超、CT和MRCP。 18例ABP行急诊内镜治疗均获成功 ,其中 9例行急性乳头括约肌切开术(EST) ,9例行鼻胆管引流术 (ENBD) ,未出现与内镜诊疗相关的并发症。 18例ABP经内镜治疗后均获得良好效果 ,1例合并胆道及肺部感染 (5 .6 % ) ,1例合并胰腺假性囊肿 (5 .6 % ) ,未出现其它并发症及死亡情况。结论 ER CP对ABP的病因诊断优于B超、CT和MRCP ,EST和ENBD是治疗ABP的理想方法。

Objective:To probe into the pathogenic diagnosis and the treatment of acute biliary pancreatitis by endoscopy.Methods Eighteen cases of emergency Endoscopy consulting of ABP in our hospital were reviewed to analyze the effect and complication of endoscopy.Results The pathogens of the 18 cases of ABP composited of choledocholith(12cases),choledocholith+cholecystic stone(1case),choledochus roundworm(1case),bile papillitis(2cases),bile papilla cancer(1case),and sphincter of Oddi dysfunction(1case).ERCP had obvious superiority in the accuracy of pathogeny diagnosis of ABP than B-ultrasonography,CT and MRCP.Moreover,the emergency Endoscopy consulting of the 18 cases of ABP had succeeded, which included 9 cases of EST,9 ENBD without any complication related to Endoscopy consulting.The 18 cases of ABP have a good curative effect,but secondary infection(1 case),pancreatic cyst(1case).there was no other complication and death case.Conclusion This paper points out that ERCP has superiority in pathogenic diagnosis of ABP than B-ultrasonography,CT and MRCP EST and ENBD are idea methods to treat ABP.