早期内镜下乳头括约肌切开治疗急性重症胆源性胰腺炎

Early EST for the Treatment of Severe Acute Biliary Pancreatitis

目的 探讨早期内镜下乳头括约肌切开 (EST)治疗急性胆源性胰腺炎的临床效果。 方法 将急性胆源性胰腺炎患者 10 2例 ,随机分为 2组 ,即EST治疗组 (简称EST组 ) 5 8例和保守治疗组(对照组 ) 4 4例。EST组在入院 3d内行ERCP加EST ,其他治疗同对照组。分别观察两组患者一月内手术率、并发症率、死亡率以及治愈率等指标。 结果 与对照组比较 ,EST组上述各项观察指标均明显降低 ,且有统计学意义。 结论 早期EST治疗急性重症胆源性胰腺炎安全有效 ,创伤小 ,恢复快 ,并发症少 ,可在一定程度上替代外科手术 。

Objective To study the therapeutic effect of early endoscopic sphincterotomy (EST)on the treatment for severe acute biliary pancreatitis(SAP). Methods 102 cases of patients with SAP were randomized divided into two groups:58 cases underwent EST treatment (EST group) and 44 cases received conservative treatment (control group). The operation rate within one month, the complication rate and mortality,the recovery rate of two groups were observed. Results The indexes measured in the EST groups were lower than those in the control group, and the differences were significant statistically. Conclusion Save and effective, less damage, quick recovery and less complications are the advantages of early EST for severe acute biliary pancreatitis.The treatment may somewhat take the place of traditional operation.