急诊十二指肠镜治疗急性胆源性胰腺炎94例

目的:探讨急诊十二指肠镜行胆胰管引流治疗急性胆源性胰腺炎的价值及可行性,扩大完善内镜在胆胰疾病中的治疗范围.方法:2004-01/2005-12急诊十二指肠镜治疗急性胆源性胰腺炎94例,治疗方式以经内镜鼻胆管引流(ENBD)为主,必要时行Oddi′s括约肌切开(EST).结果:94例患者中成功91例,成功率96.81%.无发展为重症胰腺炎患者.上腹痛症状平均症状缓解时间42.3 h;尿淀粉酶平均56 h下降到正常.内镜治疗后1 wk,复查B超,61例伴有胰腺水肿患者49例水肿消退,形态恢复正常:29例伴有胰周积液患者中21例胰周积液完全吸收,8例积液量明显减少,无伴随临床症状.结论:急诊十二指肠镜治疗急性胆源性胰腺炎是安全可靠的,可以阻止胰腺向恶性转化.

Emergency duodenoscopy for acute biliary pancreatitis:an analysis of 94 cases

AIM:To study the clinic outcomes of endoscopic naso-biliary drainage(ENBD)for acute biliary pancreatitis(ABP). METHODS:We retrospectively analyzed 94 pa- tients with ABP who had undergone emergency endoscopic examination and were treated with en- doscopic naso-biliary drainage(ENBD)from Janu- ary 2004 to December 2005.Endoscopic sphincter- otomy(EST)was also carried out in some cases. RESULTS:Ninety-one patients(96.81%)were successfully healed after emergency duodenos- copy.There were no severe complications or mortality.On average,abdominal pain symp- toms recovered within 42.3 h and amylase level within 56 h.After being treated by ENBD for 1 week,the pancreatic edema in 49 of 61 cases was resolved;peripancreatic effusion was completely absorbed in 21 of 29 patients and was obviously decreased in the remaining 8,without clinical complications. CONCLUSION:Emergency duodenoscopy is a safe and new method for treating ABP.