EST严重并发症的外科治疗

目的探讨EST术后严重并发症的外科治疗。方法收治14例EST术后并发严重出血、穿孔、胰腺炎病人。其中单纯出血5例，单纯穿孔5例，穿孔伴出血3例，穿孔伴重症胰腺炎1例。结果单纯出血4例、单纯穿孔5例、穿孔伴出血2例病人存活。单纯出血1例、穿孔伴出血2例及穿孔伴重症胰腺炎1例病人死亡。结论早期诊断，积极手术是降低死亡率的关键。对穿孔伴出血或胰腺炎的病人，为减少胆汁、胰液对EST切口的刺激，应建立通畅的腹腔引流。

Surgical management of severe complications after endoscopic sphincterotomy

Objective To investigate the surgical management of the severe complications after endoscopic sphincterotomy (EST). Methods Fourteen patients with complications after EST were surgically treated in our hospital. Of the 14 patients, 5 were with hemorrhage, 5 with perforation, 3 with perforation plus hemorrhage and 1 with perforation plus severe acute pancreatitis.Results One patient with perforation, 2 with perforation plus hemorrhage and 1 with perforation plus severe acute pancreatitis died and the others survived. Conclusions Early diagnosis and surgical intervention are very important to lower the mortality. It is important to isolate EST incision from the digestion of bile and pancreatic juice and perform an unobstructed peritoneal drainage.