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目的探讨胆源性胰腺炎的临床诊断、手术时机和手术方式。方法回顾性分析118例急性胆源性胰腺炎的临床资料。结果98例非梗阻性急性胆源性胰腺炎(83%)先行非手术治疗,待急性炎症消退后2w内行胆囊切除术,均治愈;20例行急诊手术(为梗阻性胆源性胰腺炎),其中以胰腺病变为主的重症急性胰腺炎手术8例,术后均出现不同程度的腹腔感染,2例死亡。以胆道梗阻为主的病人12例,手术解除胆道梗阻,胰腺作包膜切开引流,术后全部治愈。结论急性胆源性胰腺炎在治疗上有非梗阻性和梗阻性之分,早期均以非手术治疗为主,非梗阻性非手术治疗缓解后行择期手术,梗阻性需急诊手术;对于胰腺病变一般仅作包膜切开引流即可。
Objective To investigate the clinical diagnosis, surgical timing and surgical methods of biliary pancreatitis. Methods A retrospective analysis of 118 cases of acute gallstone pancreatitis clinical data. Results 98 cases of non-obstructive acute gallstone pancreatitis (83%) were treated with non-surgical treatment until the acute inflammation subsided 2w after cholecystectomy were cured; 20 cases of emergency surgery (obstructive biliary pancreatitis) Among them, 8 cases were treated with severe acute pancreatitis with pancreatic lesions. All cases had different degree of abdominal infection and 2 died after operation. Biliary obstruction-based patients in 12 cases, surgery to relieve biliary obstruction, the pancreas for en bloc drainage, all cured. Conclusion Acute biliary pancreatitis is non-obstructive and obstructive in the treatment. Non-operative treatment is the main method in the treatment of acute gallstone pancreatitis. Non-obstructive non-surgical treatment is elective surgery and obstructive surgery is required. For pancreatic lesions Generally only for the incision and drainage can be coated.