胆源性胰腺炎的早期治疗

目的：探讨胆源性胰腺炎早期治疗的有效方法。方法：回顾性分析273例胆源性胰腺炎早期不同治疗方法的临床效果。结果：①梗阻性重型患者10例中8例采取早期手术治疗全部痊愈，非手术治疗1例病死，1例略有好转。②梗阻性轻型患者70例中57例采取早期手术治疗全部痊愈。ERCP＋EST治疗1例，非手术治疗5例，病症缓解，但未去除根本病因，仍需择期手术治疗。③非梗阻性重型患者47例中采取早期手术治疗13例，4例死于早期多脏器衰竭：另3例采用区域动脉灌注联合早期手术治愈，30例非手术治疗全部治愈。④非梗阻性轻型患者146例中采取早期手术治疗55例，ERCP＋EST共3例，传统非手术治疗80例，均全部治愈。结论：①梗阻性胆源性胰腺炎是早期手术的绝对适应症，胆道解压和胰周引流是其基本术式；②非梗阻性重型胆源性胰腺炎原则不采取早期手术；③非梗阻性轻型胆源性胰腺炎可采取早期手术。

Early treatment of biliary pancreatitis

Objective To investigate the effective methods for early operative treatment of biliary pancreatitis.Method The clinical effects of 273 cases with biliary pancreatitis underwent early operative treatment were retrospectively analyzed.Results ①Among 10 cases with severe obstructive biliary pancreatitis,8 underwent early operation,and all of them were cured.②Among 70 cases with mild obstructive biliary pancreatitis,57 cases underwent early operation,and all of those cases were cured.③In 47 cases with severe non-obstructive biliary pancreatitis,13 cases underwent simple early operation,and 4 of those cases died of early multiple organ failure,while 3 other cases treated by regional intra-arterial in fusion combined with early operation were cured.④ In 146 cases with mild non-obstructive biliary pancreatitis,55 cases underwent early operation,and all of those cases were cured.Conclusion ①Obstructive biliary pancreatitis is an absolute indication for early operation,and the basic operation pattern is decompression of biliary tract obstruction and peri-pancreatic drainage.② In principle of severe non-obstructive biliary pancreatitis should not undergo early operation.③Early operation might be carried out in cases of mild non-obstructive biliary pancreatitis.