摘要
目的探讨腹腔镜和十二指肠镜联合治疗急性胆源性胰腺炎(acutegallstonepancreatitis,AGP)的适应证、手术方法和临床价值。方法应用腹腔镜及十二指肠镜对156例急性胆源性胰腺炎病例施行十二指肠镜下乳头括约肌切开取石(EST),并置入鼻胆管引流(ENBD);合并胆囊结石者施行腹腔镜胆囊切除术(LC);同时行胰包膜切开、坏死组织清除及Winslow孔和腹腔置管引流术。结果全组156例,其中112例胆管结石经EST取出,所有病例均行ENBD;合并胆囊结石91例,急诊或择期施行LC,86例成功,5例中转开腹。术后住院时间(15±7)d,随访6～24个月,无严重手术并发症,无1例死亡。结论两镜联合治疗AGP创伤小、腹腔干扰轻、安全有效,术后恢复快,是一种理想的治疗方法。
Objective: To investigate indication, surgical methods, and clinical value of laparoscope combined with duodenoscope in treatment of acute gallstone pancreatitis (AGP). Methods: Endoscopic sphincterotomy (EST) and endoscopic nasobiliary drainage (ENBD) were performed in 156 cases with acute gallstone pancreatitis by applying laparoscope and duodenoscope; Laparoscopic cholecystectomy (LC) was also performed in those cases with acute gallstone pancreatitis and gallbladder stones, simultaneously, pancreatic coat was opened,nerotic tissues were excluded, drainage-tubes were placed in Winslow′s foramen and abdominal cavity. Results: Choledocholithiasis was cleared up in 112 cases by EST, ENBD was performed in all patients; Urgent or routine LC was performed in 91 cases with gallbladder stones and AGP, LC in 86 cases was successful and that in 5 cases was transferred into laparotomy. Postoperative length of stay was (15±7)d. No severe operative complication has been found among patients who accepted follow-up from 6 months to 24 months. There was no death. Conclusions: Treatment for acute gallstone pancreatitis by using laparoscope and duodenoscope is an ideal approach with advantages including tiny wound, effectiveness, safty, slight interference to abdominal cavity and rapid recovery.
出处
《中国内镜杂志》
CSCD
2004年第6期9-11,共3页
China Journal of Endoscopy
关键词
急性胆源性胰腺炎
胆管结石
腹腔镜
十二指肠镜
手术治疗
acute gallstone pancreatitis
choledocholithiasis
laparoscope
duodenoscope
surgical treatment CLC number: R657.51 Document code: A
