急性胆源性胰腺炎的急诊内镜治疗

目的 探讨急性胆源性胰腺炎患者早期行内镜下逆行胰胆管造影检查和治疗的临床疗效及安全性.方法 59例急性胆源性胰腺炎住院患者,其中急诊内镜治疗31例,在一般内科治疗基础上,24～72 h内行内镜下逆行胰管造影检查和治疗 保守治疗（对照组）28例,观察两组的疗效和安全性.结果 内镜下逆行胰管造影组治愈率为94.74%,明显高于对照组的80.95%（P〈0.05）,未发生与内镜操作有关的严重并发症.与对照组相比,内镜下逆行胰管造影组平均住院时间、腹痛缓解时间、淀粉酶恢复正常时间、体温及白细胞复常时间等临床指征均明显短于对照组（P〈0.01）.结论 急诊内镜下逆行胰管造影治疗急性胆源性胰腺炎具有微创、安全、有效,可快速解除胰胆管开口的阻力及防止胆汁胰管反流,抑制病情的进一步恶化,是治疗急性胆源性胰腺炎的理想方法.

Emergency endoscopic retrograde cholangiopancreatography and endoscopic therapy for patients with acute biliary pancreatitis

Objective To evaluate the safety and effect of early therapeutic endoscopic retrograde cholangiopancreatography（ERCP） for patients with acute biliary pancreatitis. Methods The clinical dataof 59 patients with acute biliary pancreatitis were analyzed. In those patients ,31 were treated with emergency ERCP （ERCP group）, and 29 were treated with conservative treatment（ control group）. Results The 31 patients received ERCP were all successfully finished the examination and therapy. The status of their disease was improved, and no severe complications occurred correlation with ERCP. The time of hospitalization was significantly shorter （P 〈0. 01 ） and the symptoms and signs in 94. 74% cases of ERCP group disappeared faster in patients treated with ERCP than those with conservative treatment （ P 〈 0. 01 ）, and the mortality was decreased. Conclusion Emergency ERCP is micro - invasive and highly effective in the treatment of acute biliary pancreatitis safely, and may play an important role in the early treatment of acute biliary pancreatitis and can prevent further progression to severe status, as well as significantly decrease the mortality rate.