胆源性胰腺炎

急性胆源性胰腺炎EST治疗的基础及临床研究

Experimental and Clinical Research of Early EST in Acute Biliary Pancreatitis

目的探讨急诊腹腔镜手术治疗急性胆源性胰腺炎（AcuteBiliaryPancreatitis，ABP）可行性及疗效。

Objective To explore the feasibility and effect of emergent laparoscopic surgery for the treatment of acute biliary pancreatitis .

急性胆源性胰腺炎（AcuteBiliaryPancreatitis，ABP）是当前临床上常见疾病之一，病理生理机制极为复杂，目前仍是学者争论和研究的热点。

Acute biliary pancreatitis is one of commonly clinical disease , whose pathophysiology mechanism is very complicated and disputable .

EST组38例，无胆源性胰腺炎复发（0/38）；

None had recurrent pancreatitis in all 38 cases of EST group ( 0 / 38 );

EST和ENBD治疗胆源性胰腺炎

Clinical analysis on EST and ENBD in treatment of acute biliary pancreatitis

研究背景：急性胆源性胰腺炎（AcuteBiliaryPancreatitis，ABP）和胰腺癌是目前常见的重症胰腺疾病。

Background Acute pancreatitis biliary ( acute pancreatitis biliary ABP ), and pancreatic cancer are the most common critical of pancreatic diseases .

目的探讨胆源性胰腺炎（GP）病人胆道结石的处理方式和时机。

ObjectiveTo investigate reasonable operative model and timing of biliary lithiasis of patients with gallstone pancreatitis ( GP ) .

方法：30例胆源性胰腺炎患者经LC、LC+EST、LC+纤维胆道镜检查及取石术治疗。

Methods : 30 patients with biliary pancreatitis were treated by LC , LC + EST and LC + fibre cholecyst endoscope .

早期ENBD和EST治疗急性胆源性胰腺炎135例分析

Clinical study of early ENBD and EST treatment for 135 cases of acute biliary pancreatitis

目的探讨内镜下奥狄括约肌切开（EndoscopicSphincterotomy，EST）预防急性胆源性胰腺炎复发的临床效果。

Objective To study the clinical efficacy of endoscopic sphincterotomy ( EST ) for preventing the recurrence of acute gallstone pancreatitis .

目的评价急性胆源性胰腺炎患者早期行内镜逆行胰胆管造影（ERCP）及介入治疗的安全性和临床疗效。

To evaluate the safety and effect of early therapeutic endoscopic retrograde cholangiopancreatography ( ERCP ) for patients with acute biliary pancreatitis .

急性胆源性胰腺炎（ABP）约占急性胰腺炎的15%~50%。

The 15 % ~ 50 % of acute pancreatitis ( AP ) is acute biliary pancreatitis ( ABP ) .

并随机抽取同期68例诊断为急性胆源性胰腺炎（ABP）的患者作为对照组。

68 patients with acute biliary pancreatitis ( ABP ) diagnosed over the same period were served as control group .

非EST组74例，14例胆源性胰腺炎复发（14/74），复发率为18.9%，两组有显著统计学意义（P<0.01）。

14 had recurrent pancreatitis in all 74 cases of non-EST group ( 14 / 74 ), the recurrence rate was 18.9 % , P < 0.01 ?

方法对急性胆源性胰腺炎首先行内镜下乳头括约肌切开取石（EST），同时置入鼻胆管引流（ENBD）；

Methods Endoscope sphincterotomy ( EST ) was conducted in the acute biliary pancreatitis together with endoscope nasobiliary drainage ( ENBD ) .

方法：91例次急性胆源性胰腺炎患者作ERCP及内镜治疗，其中轻型胰腺炎78例，重症胰腺炎13例。

METHODS : Ninety-one patients with acute biliary pancreatitis including 13 patients with severe acute biliary pancreatitis in the ERCP group underwent ERCP and endoscopic therapy .

目的：超声和内窥镜逆行胰胆管造影术（ERCP）对急性胆源性胰腺炎病人的胆总管形态学所见进行对照研究。

Objective : To compare the morphologic findings of the common bile duct by ultrasonography and endoscopic retrograde cholangiopancreatography ( ERCP ) in patients with biliary acute pancreatitis .

结论：胃肠道功能障碍≥5天、胆源性胰腺炎、早期胰腺明显坏死和腹腔灌洗引流等是SAP自期胰腺感染的主要易感因素。

Conclusion : Gastrointestinal tract dysfunction ≥ 5 day , biliary pancreatitis , obviously pancreatic necrosis in earlier period and abdominal lavage are principal predisposing factors of pancreatic infection in earlier period of SAP .

目的为提高急性胆源性胰腺炎（AGP）的治疗效果，探索AGP早期手术适应证及最佳手术时机。

Objective To study the therapeutic effects and explore the early surgical indication and optimun operation timing in patients with acute gallstone pancreatitis ( AGP ) .

放置胃管≥7天、肠切能障碍≥5天、施行腹腔灌洗手术、胰腺有坏死及胆源性胰腺炎等危险因素与SAP患者继发胰腺感染的发生率明显相关（P＜0.05）；

Risk factors , including detaining gastric canal ≥ 7 day , bowels dysfunction ≥ 5 day , performing abdominal lavage , pancreatic necrosis and biliary pancreatitis were significantly correlated with the incidence rate of secondary infection of pancreas in SAP ( P < 0.05 );

方法：对30例ABP患者（内镜组）进行ERCP／EST／ENBD治疗，其中轻症急性胆源性胰腺炎（MABP）20例、重症急性胆源性胰腺炎（SABP）10例。

Methods 30 patients with acute billiary pancreatitis ( ABP ), including 20 MABP and 10 SABP , underwent ERCP / EST / ENBD ( ERCP group ) .

方法观察老年胆源性胰腺炎18例，全部病例均采用手术治疗，其中24h内手术者16例，72h内手术2例，全部病例均行胆囊切除、胆囊管引流。

Methods 18 cases of such patient were underwent the operation ( among them 16 cases within 24 h and 2 cases within 72 h ) . All cases were cholecystectomy and bile duct drainage .

目的探讨血清总胆红素（TBIL）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）对诊断胆源性胰腺炎的临床意义。

Objective To study the clinical significance of total bilirubin ( TBIL ), alanine aminotransferase ( ALT ), aspartate aminotransferase ( AST ), alkaline phosphatase ( ALP ) in serum for diagnosing acute gallstones pancreatitis ( AGP ) .

目的探讨早期内镜治疗急性重症胆源性胰腺炎（ASBP）的临床疗效及安全性。

Objective To study the clinical value and safety of endoscopic treatment for acute severe biliary pancreatitis ( ASBP ) .

结论胆源性胰腺炎应严格掌握胆道探查指征，术前MRCP检查可显著降低术中胆总管探查阴性率，MRCP有助于判断胆源性胰腺炎是否需行胆道探查。

Conclusions The preoperative MRCP is able to provide more exact findings of biliary system and can significantly decrease the negative rate of intraoperative CBD exploration , therefore it is beneficial to make the decision of CBD exploration in gallstone pancreatitis intraoperatively .

急性梗阻化脓性胆管炎（AOSC）和胆源性胰腺炎（BOAP）的病人，生命体征不稳定有严重并发症的行ENBD。

Patients with acute obstructive suppurative cholangitis ( AOSC ) and bile-original acute pancreatitis ( BOAP ), who had severe complications and whose life signs were not stable , were given ENBD .

方法通过回顾分析143例AGP病人并将其分为梗阻性胆源性胰腺炎（OAGP）及非梗阻性胆源性胰腺炎（NOAGP）2组。

Methods 143 cases of AGP were retrospectively analysed and were devided into two groups : AGP with biliary obstruction ( OAGP ) and with no biliary obstruction ( NOAGP ) .

急性胆源性胰腺炎78例临床治疗分析

Clinical Analysis of Treatment for 78 Cases with Acute Gallstone Pancreatitis

胆源性胰腺炎的外科治疗急性胆源性胰腺炎诊治分析

Current Concept on Acute Biliary Pancreatitis Surgical treatment of Gallstone Pancreatitis

内镜治疗急性重症胆源性胰腺炎的临床疗效及安全性

Value and safety of endoscopic treatment for acute severe biliary pancreatitis