ERCP对腹腔镜胆囊切除术后急性胰腺炎的早期治疗效果

Value of ERCP in Early Diagnosis and Treatment of Acute Pancreatitis after Laparoscopic Cholecystectomy

目的:观察ERCP对腹腔镜胆囊切除术(laparoscopic cholecystectomy LC)后出现急性胰腺炎(acute pancreatitis AP)的早期治疗效果。方法:收集2005年6月至2013年12月47例AP患者(均是胆囊结石腹腔镜胆囊切除术后),所有患者住院行ERCP + EST治疗,术中放置鼻胆管(Endoscopic naso-biliary drainage, ENBD)9例,胆管支架4例。结果:术中发现胆总管结石36例,9例胆总管下端狭窄,2例胆总管下端恶性肿瘤。术后未出现十二指肠穿孔、胰腺炎加重等严重并发症。结论:胆道因素依然是LC术后急性胰腺炎的首要因素,ERCP治疗腹腔镜胆囊切除术后急性胰腺炎有显著疗效。

Objective: To investigate the value of endoscopic retrograde cholangiopancreatitis (ERCP) in early diagnosis and treatment of acute pancreatitis after laparoscopic cholecystectomy (LC). Methods: The data of 47 cases with acute pancreatitis after LC in our hospital from June 2005 to December 2013 were retrospectively analyzed. All cases were treated with ERCP + EST, 9 cases were cured with ENBD, 4 cases were placed stent. Result: 36 cases were choledocholithiasis, 9 cases were common bile duct stricture, 2 cases were maligment, and there was no severe complication after ERCP, such as gastroduodenal perforation. Conclusion: The major cause of acute pancreatitis after LC was biliary factor. For these cases, the treatment by ERCP was safe and effective.