轻症急性胆源性胰腺炎内镜治疗价值

目的 评价早期内镜治疗轻症急性胆源性胰腺炎的价值及远期并发症.方法 将131例轻症急性胆源性胰腺炎患者随机分为2组,44例行保守治疗(保守组),87例在72h内行内镜治疗(内镜组).比较其腹痛缓解时间,血淀粉酶、肝功能恢复时间及复发率等.结果 内镜组较对照组治疗后血淀粉酶、肝功能及体温恢复正常时间,腹痛缓解时间、腹部体征消失时间明显缩短(P<0.05).122例患者平均随访18个月(3~42个月),9例失访,随访率93.1%.内镜组的胰腺炎复发率0%(0/83)明显低于对照组15.4%(6/39)(P=0.001)).结论 早期内镜治疗对于轻症急性胆源性胰腺炎是一种有效而安全的方法,尤其适用于有明显黄疸、感染、结石嵌顿的病例,并能减少胰腺炎的复发.

Value of endoscopic therapy for patients with mild acute biliary pancreatitis

Objective To evaluate the value and long-term complication of early endoscopic therapy for patients with mild acute biliary pancreatitis(MABP).Methods One hundred and thirty-one cases of ABP were randomly divided into two groups,non-ERCP conservative group(n =44),and therapeutic ERCP group(n =87) in which early endoscopic therapy was performed within 72 hours.Changes of clinical symptoms and laboratory indexes were recorded accordingly.Follow-up of recurrence was made for all the patients.Results The days of normalization of serum amylase,hepatic function indexes and body temperature,relief of abdominal pains and signs were significantly shorter in therapeutic ERCP group than that in control group(P <0.05).One hundred and twenty-two patients followed-up for average 18(range 3～42) months.The recurrence rate in the ERCP group 0%(0/83) was significantly lower than that in the control group 15.4%(6/39)(P =0.001).Conclusion Early endoscopic therapy is an effective and safe method for MABP,especially for those with severe jaundice,bile duct infection and/or biliary colic,and also effective in prevention from recurrence.