老年急性胆源性胰腺炎60例诊治体会

目的总结分析老年急性胆源性胰腺炎的临床特点及治疗经验。方法对2002年1月-2008年8月收治的60例老年胆源性胰腺炎进行回顾性分析。结果胆囊结石14例，胆总管结石18例，胆囊结石并发胆总管结石24例，肝内胆管结石并发胆总管结石4例。入院后均首先给予非手术治疗，其中12例行急症手术治疗，48例行择期手术治疗。住院期间出现内科并发症13例，手术后并发症8例。治愈58例，死亡2例。结论老年胆源性胰腺炎患者以胆石病为主要病因。早期以非手术治疗为主，待病情稳定后，择期手术解除梗阻，可减少并发症，降低病死率。

Diagnosis and Treatment of Senile Acute Biliary Pancreatitis: a Report of 60 Cases

Objective To summarize the clinical features and therapeutic experience of senile acute biliary pancreatitis. Methods The clinical data of 60 cases with senile acute biliary pancreatitis from January 2002 to Auguest 2008 analyzed retrospectively. Results The causes were the follow： cholecystolithiasis （ 14 cases）, choledocholithiasis （ 18 cases）, eholeeystolithiasis complicated with choledocholithiasis（24 cases） and hepatolithiasis complicated with choledoeholiithiasis（4 cases）. All cases received the conservative treatment after admission. Twenty cases underwent emergency operation. 48 cases underwent selective operation. The medical problems occurred in 13 cases and postoperative complications in 8 cases. 58 eases were cured and 2 cases died. Conclusion The main cause of senile acute biliary pancreatitis appears to be eholelithiasis. The early conservative treatment followed by selective operation when the state is stable can reduce the complications and mortality.