胆道及胰腺手术后发生急性胰腺炎临床分析

目的 结合既往有胆道、胰腺手术史的急性胰腺炎发作的临床资料，分析、评价手术与急性胰腺炎发生的相关性及其临床表现等特点。方法 收集、整理2003.1-2006.3西安交通大学医学院第一医院348例急性胰腺炎病历资料。全部资料符合急性胰腺炎诊断标准﹙1996年中华医学会外科分会胰腺组制定二次方案﹚。根据研究要求，整理伴有胆道，胰腺手术史的病例67例，结合资料从手术方式、手术与发病间歇、住院天数、Balthazar CT分级、Ranson入院48小时评分，进行分析、总结。所有结果采用x±SD,SPSS13.0软件分析。结果 曾有胆道胰腺手术史的急性胰腺炎发作，与胆总管结石、胆泥沉积，奥狄氏括约肌功能、奥狄氏括约狭窄有关；腹腔镜胆囊切除术( laparoscopy cholecystectomy LC)与开腹胆囊切除术后（open cholecystectomy OC）胰腺炎在住院天数、术后距急性胰腺炎发作间隔无统计学意义。所有病例系痊愈出院。58例随访，无胰腺炎再次发作。 结论 伴有胆道、胰腺手术史的胰腺炎急性发作，在治疗上仍以支持，对症为主，但要重视病因诊治，在病情平稳后进行ERCP﹙endoscopic retrograde cholangiopancreatography﹚检查，重点观察胰管，胆总管下端及奥迪氏括约肌功能，减少并控制胰腺炎复发可能性，提高生活质量

Clinical evaluation on acute pancreatitis attact with operation-pancreatic

【Absract】 Objective The purpose of this study was explored to the relation of acute pancreatitis with operation of pancreas-biliary tract . Methods Clinical dates ,which the interval was within half of a year or beyond a year from surgery to firstly acute pancreatitis attack, were analyzed according to what operations has been done, length of stay, Balthazar CT, Ranson scores. The reseaches were applied by SPSS.13.0 software. Results Of 348 patients with acute pancreatitis , after operation of pancreas-biliary tract, 66 patients with acute pancreatitis firstly resulted from sulduge, sphincter of oddi dysfunction ﹙SOD﹚，common bile duct﹙CBD﹚stones. and so. As to acute pancreatitis with operation of pancreas-biliary tract, It was not significantly different between the interval within half of a year and the interval beyond a year from surgery to firstly acute pancreatitis attack ﹙P﹥0.05﹚.58 cases follow-up were no attack . Conclusion It is imporment that ERCP ﹙endoscopic retrograde cholangiopancreatography﹚would be performed for cases of acute pancreatitis with operation of pancreas-biliary tract . and especially the cause of it were disclosed to prevent from recurrent pancreatitis.