[1]张成,安东均,陈阁.内镜治疗重症急性胆源性胰腺炎的临床研究[J].中国微创外科杂志,2008,08(1):52-53.
　Zhang Cheng,An Dongjun,Chen Ge..Endoscopic Treatment for Severe Acute Biliary Pancreatitis[J].Chinese Journal of Minimally Invasive Surgery,2008,08(1):52-53.
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内镜治疗重症急性胆源性胰腺炎的临床研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年1期
页码:
52-53
栏目:
出版日期:
2008-10-22

文章信息/Info

Title:
Endoscopic Treatment for Severe Acute Biliary Pancreatitis
作者:
张成; 安东均; 陈阁
陕西省咸阳市中心医院肝胆胰外科，咸阳712000
Author(s):
Zhang Cheng;  An Dongjun;  Chen Ge.
Department of Hepatobiliary Pancreatic Surgery, Xianyang Central Hospital, Xianyang 712000, China
关键词:
内镜下鼻胆管引流术; 重症急性胆源性胰腺炎
Keywords:
Endoscopic nasobiliary drainage; Severe acute biliary pancreatitis
分类号:
R657.5
文献标志码:
A
摘要:
目的探讨内镜治疗重症急性胆源性胰腺炎(severe acute biliary pancreatitis，SABP)的价值。方法36例入院确诊为SABP后急诊手术。16例合并急性胆囊炎、胆囊结石，行内镜下鼻胆管引流术(endoscopic nasobiliary drainage,ENBD)；11例合并缩窄性乳头炎或胆总管结石，行内镜下乳头切开术(endoscopic sphincterotomy,EST)及ENBD；4例弓形刀及造影导管插入胆总管困难，选用针形刀行EST，并行ENBD；2例造影导管插入胆总管时，导丝反复进入胰管3次以上，用弓形刀切开十二指肠乳头括约肌后，寻找胆管开口，施行ENBD；3例行ENBD失败后改开腹手术。全组术后配合系统的内科治疗。结果ENBD成功施行33例，其中治愈29例，治愈率81％（29/36），死亡4例，病死率11％（4/36）。失败3例。术后胰周感染3例，无十二指肠乳头出血、十二指肠穿孔及胆管炎。全组住院时间15～75 d，平均22 d。26例成功者随访12～36个月，平均18个月，无胰腺炎症状复发。结论内镜治疗重症急性胆源性胰腺炎，配合系统的内科治疗，可明显减少患者的痛苦,缩短病程,提高治愈率。
Abstract:
ObjectiveTo evaluate the value of endoscopic treatment for severe acute biliary pancreatitis (SABP).MethodsA total of 36 patients with SABP, who received emergency operation were enrolled into this study. Among the patients, 16 received endoscopic nasobiliary drainage (ENBD) because of acute cholecystitis or cholecystolithiasis; 11 underwent endoscopic sphincterotomy (EST) and ENBD due to stenotic papillitis or choledocholithiasis; 4 were treated with EST using needle knife and ENBD due to difficulties in inserting bow knife and cannula catheter into the common bile duct; and 2 experienced the guide wire entering into the wirsung’s duct for over 3 times, when the cannula catheter was inserted into the common bile duct. Thus, the sphincter of Oddi was incised by bow knife to expose the opening of the cystic duct, and then ENBD was performed. Open surgery was performed in 3 cases because of failure of ENBD. In all the patients, systemic medical treatment was carried out after the operations.ResultsENBD was completed in 33 cases, among which 29 (81%) patients were cured and 4 (11%) patients died. The operation failed in 3 cases. After the operation, 3 patients developed peripancreatic infection. No hemorrhage of the duodenum papilla, duodenal perforation, or cholangitis occurred in this series. The mean hospital stay was 22 d (15-75 d). 26 of the cured patients were followed up for 12-36 months (mean, 18 months), no recurrence of the symptoms of pancreatitis was found.ConclusionsEndoscopic treatment combined with systemic medical therapy may reduce the course of disease and increase the cure rate for patients with SABP.

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更新日期/Last Update: 2013-10-22