经内镜治疗急性胆源性胰腺炎80例临床报告

目的 观察内镜治疗急性胆源性胰腺炎的疗效及其并发症。方法 80例急性胆源性胰腺炎患者在抗炎抑酶等综合治疗的基础上，行内镜（1-3d内）逆行胰胆管造影（ERCP）及经内镜十二指肠乳头括约肌切开（EST）或鼻胆管引流（ENBD）等治疗。结果 经内镜治疗后72例（90％）急性轻症胆源性胰腺炎（MABP）患者2—5d体温恢复正常；急性重症胆源性胰腺炎（SABP）患者3—8d腹部体征好转。血常规、淀粉酶及血生化1、2周内基本恢复，平均住院18．7d。8例形成急性坏死性胰腺炎转外科手术，平均住院65．9d．3例死亡。内镜治疗过程中5例出现十二指肠乳头括约肌切口出血，经局部喷洒凝血酶止血外，未再出现其他并发症。结论 急性胆源性胰腺炎早期ERCP及内镜治疗安全有效。

Clinical report of endoscopic therapy of biliary obstructive acute pancreatitis 80 cases

[Objective] To observe the success rate, theraputic effects and complications of endoscopic therapy in patients of Biliary obstructive Acute Pancreatitis(BOAP). [Methods] Based on comprehensive treatment including anti-inflammatory and anti-enzyme therapy, 80 patients of BOAP who underwent ERCP, EST OR ENBD within 3 days were analyzed retrospectively. [Results] Among 80 patients who underwent endoscopic therapy, 90%(72/80) had favorable results. After therapy, patients who had fever came back to normal body temperature in 2~5 days, patients who had peritonitis had better physical sign in 3~8 days. All 72 patients turned to normal range of blood test results, biochemical test results and blood amylase level in 1~2 weeks and were discharged in 5~30 days. 10%(8/80) of 80 patients who had acute necrotic pancreatitis were transferred to surgical therapy. During endoscopic therapy, 5 patients presented incision site hemorrhage of sphincter of papilla of duodenum, no other complications were observed. [Conclusion] Early endoscopic therapy is safe and effective in BOAP patients,the therapy should be performed as early as possible to reduce the risk of severe acute pancreatitis.