急性胆源性水肿性胰腺炎胆道手术时机探讨

目的 :探讨急性胆源性水肿性胰腺炎的胆道手术时机。方法 :对 86例急性胆源性水肿性胰腺炎患者治疗进行回顾性分析 ,根据手术时间分为 3组 :1周以内为早期组 ,1～ 2周为延期组 ,2～ 4周以后为择期组 ,18例未手术为对照组。结果 :手术组较未手术组复发率明显降低 ,早期手术组比延期及择期组手术风险并未增加 ,预后良好 ,胰腺炎复发率、住院日明显减少。结论 :急性胆源水肿性胰腺炎应以胆道手术治疗为原则 ,并以早期手术为好。

A Study of the Opportunity of Biliary Tract Operation on Acute Edematous Biliary Pancreatitis

Objective:To investigate the opportunity of biliary operation on acute edematous biliary pancreatitis.Methods:86 patients with acute edematous biliary pancreatitis were retrospectively analyzed, 68 cases received biliary tract operation were divided into three groups according to the operative time, early stage group (within 1 week), prolonged stage group(1～2 weeks), and selective stage group( more than 2～4 weeks), and the other 18 cases who received nonsurgical treatment were regarded as the control group.Results:The recurrence rate in the surgical group was significantly lower than that in the control group, the operative danger in the early stage group was not increased than that in the prolonged and selective stage groups, but recurrence was signifcantly lower, hospital days and cost were decreased signifcantly in the early stage group with good operative results. Conclusions:The gallbladder had influenced on the onset of acute biliary pancreatitis, biliary tract gurgical treatment should be the pimary treatment for acute biliary edematous pancreatitis, and avoid distrubance of pancrease, early stage operation is the best operative opportunity because it could prevent recurrence and aggravation of biliary pancreatitis, and accelerate the recovery and shorten the course of the disease.