胆源性胰腺炎的胆道探查及其定义

目的：探讨胆源性胰腺炎胆道探查的必要性.方法:总结我院近十年37例胆源性胰腺炎的胆道探查情况,其中28例直接切开胆总管探查,9例用胆囊切除后经胆囊管残端插管造影及扪诊的方法探查.结果:术中探查及术后T管造影示无结石为33例,占89.2%(33/37);有结石为4例,占10.8%(4/37).其中3例术前发现有胆总管(CBD)结石,其余34例诊断为"胆源性胰腺炎",而术前影像学诊断无胆总管结石,做胆总管探查,仅有一例有结石.结论:应当正确定义"胆源性胰腺炎",胰腺炎发生时应严格限制作胆道探查.

Bile duct exploration for patients with and biliary pancreatitis discussion of the concept

Objective:To discuss the necessity of common bile duct exploration for biliary pancreatitis.Methods:37 cases of common bile duct exploration for biliary pancreatitis from 1991 till 1999 were analyzed. 28 cases were explored by choledochostomy during operation, and 9 cases of cholangiography by gallbadder duct catheterization after cholecystectomy.Results:There were 33 cases of billiary stone negative in total 37 cases(89.2%). And 4 cases of billiary stone positive(10.8%),of which 3 were confirmed CBD stone pre operation. In other 34 cases of common bile duct exploration stone was found in only one case,with very low positive rate of CBD stone.Conclusion:In common bile duct exploration for billiary pancreatitis, the "billiary" pancreatitis widely used in clinic should be strictly defined and the indications should be strictly limited.