胆源性胰腺炎的诊断和治疗

目的 探讨胆源性胰腺炎的诊断方法和治疗效果.方法 回顾性分析10年来236例胆源性胰腺炎的临床资料.患者年龄16~76岁,男108例,女128例.结果 急性间质水肿型胰腺炎211例(89.4%),急性坏死性胰腺炎25例(10.5%),胆囊源性胰腺炎142例(60.1%),胆管源性胰腺炙94例(39.8%).全组开始均先用药物治疗,210例(88.9%)治愈后施行择期手术,11例(4.6%)治疗无效施行早期手术;10例(4.2%)施行急诊手术,其中1例死亡.5例内镜下治疗(2.1%).结论 胆源性胰腺炎大多数可先行药物保守治疗后,根据病变类型施行择期手术.若治疗无效,发生化脓性胆管炎或胰腺坏死感染,则须早期或急诊手术治疗,现今在内镜下治疗,效果良好.

Diagnosis and treatment of biliary pancreatitis

Objective To explore the diagnostic methods and the effect of treatment.Methods The clinical data of biliary pancreatitis in 236 cases for 10 years were analyzed retrospectively.There were acute interstitial edematous pancreatitis in 211 cases(89.4%),and acute necrotizing pancreatitis in 25 cases(10.5%) in pathology.Results All cases were treated with medicine at first.There were selective operation after cure of drugs in 210 cases(88.9%) and early operation were performed in 11 case(s 4.6%) because without effect,10 cases(4.2%) must do emergent operation,of them 1 case(10%) died from emergent operation.Endoscopic therapy in 5 cases(2.1%).Total mortality in all cases was 0.42%.Conclusion Majority cases of biliary pancreatitis should be treated with conservative procedure at first and then selective operation were performed.Biliary pancreatitis may result from suppurative cholangitis and pancreatic necrosis with infection,it need emergent or early operation if conservative therapy failure.Nowadays,endoscopic therapy may achieve good effect.