十二指肠镜治疗急性胆源性胰腺炎的临床应用

目的探讨利用十二指肠镜行乳头切开术(EST)治疗因胆总管下端由结石、蛔虫引起嵌顿及缩窄性Vater乳头炎等所致急性胰腺炎的价值。方法本组76例由上述病因起病,患者于入院6～12h行内镜ERCP证实后,同时行EST及网篮取结石、蛔虫,送回较大结石置于胆总管(CBD)远端,同时置鼻胆管引流术(ENBD)。使胰液及胆汁引流通畅,从而解除梗阻,达到胰胆管减压。结果本组64例急诊Ⅰ期治愈;12例结石较大、2例取石或不能耐受Ⅰ期取石,行Ⅱ期取石。结论EST是一种有效治疗急性胆源性胰腺炎的微创方法。针对病因治疗,对病人创伤轻、易恢复、治疗效果确切。

Exploration of duodenoendoscopy for treatment of acute pancreatitis with gallstone

Objective To evaluate the value of EST using duodenoendoscopic in treatment of acute pancreatitis with gallstone caused by calculus or ascarid in the end of CBD.Method76patients who after verified through ERCP with endoscope within6to12hours in hospital are treated with EST,at the same time,the calculus or ascarid are taken out with net and the bigger ones are put back in the CBD far from the end,and meanwhile the ENBD is also put in it.This method can make pancreatitis juice and bile flow unblocked in order to reduce the pressure of pancreatic bile duct.Results64patients have been cleared in phaseⅠ.12patients been treated in phase II because they have too big calculus to be taken out once and they cannot bear the pain.Conclu sion EST is an effective way of treating acute bile pancreatitis.Focusing on the cause of disease,the treatment leaves small wound and makes patients recover.The effect is quite conspicuous.