急性胆源性胰腺炎的内镜治疗体会(附112例报告)

目的 探讨应用十二指肠镜及腹腔镜治疗急性胆源性胰腺炎（acute gallstone pancreatitis,AGP）的可行性、有效性和安全性。方法 对我院1996年5月－2002年5月收治的112例急性胆源性胰腺炎首先内镜下乳头括约肌切开取石（EST），同时置入鼻胆管引流（ENBD）；合并胆囊结石者，待胰腺炎恢复后，施行腹腔胆囊切除术（LC）。结果 全组112例中，78例胆管结石行EST取出，所有病人均行ENBD；胰腺炎顺利治愈107例，治愈率95.5%；合并胆囊结石85例，恢复期行LC，82例顺利切除胆囊，3例中转开腹全部治愈，25例经过非手术治愈，占22.3%，87例行腹腔镜探查或开腹探查手术，占77.7%。结论 EST＋ENBD能有效治疗急性胆源性胰腺炎，伴胆囊结石者联合应用LC，使微创手术的优点在该病整个疗程中得以体现，不失为目前理想的治疗方法。

ENDOSCOPE FOR TREATMENT OF ACUTE GALLSTONE PANCREATITIS

Objective To investigate the effective duodendoscopy and laparoscopic for the treatment of severe acute gallstones pancreatitis underwent.Methods From May 1996 to May 2002,among 112 patients for the treatment of acute pancreatitis with gallstone,endoscope sphincterotomy(EST) and endoscope nasobiliary drainage(ENBD).Laparoscopic cholecystectomy(LC) was carried out in the cases with cholelithiasis.Results Among the 112 cases,78 cases underwent EST to remove the stone.ENBD was carried out in all the cases.107 cases were cured with the effective rate of 95.5%.85 cases were complicated with cholelithiasis and laparoscopic cholecystectomy was conducted in the recovery stage.Conclusion EST and ENBD are effective treatment for acute biliary pancreatitits.Laparoscopic cholecystectomy should be carried out in the cases with cholelithiasis to reduce the operative trauma.