内镜介入治疗急性胆源性胰腺炎的现状

急性胆源性胰腺炎(ABP)约占急性胰腺炎的15%~50%。目前对于内镜介入治疗ABP的作用较为肯定,即内镜逆行性胆胰管造影术(ERCP)在ABP的病因诊断中仍具有其他方法不可替代的作用,而相应的介入治疗可清除胆管结石、恢复胆流、减少胆汁胰管反流,从而使病情迅速缓解并可以减少复发,改善总体预后,疗效明显优于传统常规治疗。尽管在内镜介入治疗的时机及指征上仍存在一定争议,但多数学者倾向于早期ERCP及内镜治疗,从而阻断急性胰腺炎的病理过程,同时也减少有关并发症的发生。目前还强调应对不同患者采取个体化的内镜治疗。

The Study on Endoscopic Interventional Treatment for Acute Biliary Pancreatitis

The 15%～50% of acute pancreatitis(AP) is acute biliary pancreatitis (ABP).At present,the effect of endoscopic interventional treatment for ABP is confirmed,that is to say ERCP is not succedaneous compared to other methods in the diagnosis of ABP.And endoscopic interventional treatment is superior to conventional therapy in cleaning calculus of bile duct,regaining bile flow,decreasing bile contraflow to pancreatic duct,and then relieving pathogenetic condition,reducing recurrence and improving prognosis.Although there are some controversies on the time and indication of endoscopic interventional treatment,the majority of scholars intend to apply ERCP and endoscopic treatments in early stage to inhibit pathologic process and reduce the related complication.Today,It is emphasized that individualized endoscopic treatment should be adopted by the patient′s own condition.