胆源性胰腺炎的诊治探讨

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11年来281例胆源性胰腺炎的临床资料。结果：236例(83．9％)为急性间质水肿型胰腺炎，45例(16．O％)为急性坏死性胰腺炎。胆囊源性胰腺炎17l例(占60．8％)，胆管源性胰腺炎110例(占39．1％)。全组均先经药物治疗，226倒(80．4％)治愈后行延期手术，22例(7．8％)行早期手术。33例(11．7％)行急症手术中死亡3例(占9．O％)。全组病死率为1．06％。结论：在临床上胆源性胰腺炎可分为胆囊源性和胆管源性两种类型，在治疗上有非梗阻性和梗阻性之分。首先均应先予以药物保守治疗为宜，前者容易保守治愈后行择期手术，后者可能并发化脓性胆管炎和胰腺坏死，需急症手术或保守治疗无效时则需早期手术。

Diagnosis and treatment of biliary pancreatitis(with an analysis of 281 cases)

Objective:To explore the diagnostic methods and the effect of treatmemt of biliary pancreatitis.Methods:The clinical data of biliary pancreatitis in 281 cases for 11 years were analyzed retrospectively.Results:There were acute interstitial edmatous pancreatitis in 236 cases(83.9%) and acute necrotizing pancreatitis in 45 cases(16.0%) in pathology. 171(60.8%) cases were cholecystic pancreatitis and 110(39.1%) cholangeitic pancreatitis. All cases were treated with medicine at first. There were postponent operation after cure of drugs in 226(80.4%) and 22 cases early operation were performed. 33 cases(11.7%) must needs do emergent operation and death from emergent operation in 3(9.0%). Total mortality was 1.06%.Conclusion:Biliary pancreatitis may divided two types of cholecystic pancreatitis and cholangeitic pancreatitis and may divided of non obstructive or obstructive at treatment. All cases should treatment with conservative procedure at first and then postponent operation were performed. Cholangeitic pancreatitis may follow by suppurative cholangitis and pancreatic necrosis,it need emergent or early operation if conservative therapy failure.