摘要
分析82例急性胆石性胰腺炎早期手术时的胆道系统和胰腺病理改变。结果表明:重症胰腺炎病理改变占20.9%,住院期间死亡率3.7%。胆囊结石发现率为85.5%,其中多数性结石占71.1%,胆总管结石发现率为36.8%,胆管扩张占53.8%;胆囊管明显变粗,推测曾有过胆囊排石者占26.4%;68例术后造影发现有胆-胰汇合异常长型通道者占20.1%,胆管远段狭窄占9.3%。以上资料说明急性胰腺炎诱发因素与反复胆囊排石导致胆管结石梗阻和胆管狭窄有明显关系,也与胆胰汇合异常有关(三种因素共占64.4%)。作者认为若胆石性胰腺炎诊断明确,早期手术对愈后有利。
Eighty two cases of acute gallstone pancreatitis on early operation are reported and the sugnficance of the clinical picture and pathology are analysed.The data showed that gallstone was found In 85.5%,among the cases of them mulliple gallstone was 71.1%.dilated cystic ducr was 26.4%,com-mon bile duct stone 36.8%,distal bile ductal stricture was found in 9.33%,and anomalous conjunction of biliary and pancreatic duct was 20.1%.Sixteen cases with serious pancreatitis were determined on oper-ation,but death rate was 3.7.¼only.The autbors claim that early operation may be of value in patlents of acute gallstone pancreatitis with or without jaundice espesially in bile duct obstruction.
作者
张陪明
王根蓉
刘德华
王维平
Zhang Peiming;Wung Genrong;Liu Dehua(Surgical Departmenut,Five Hospital Stchuan Province,Chengdu,610031)
关键词
胆石
胰腺炎
胆-胰汇合异常
胆管狭窄
Gallstone
Pancreatitis
Bile ductal stricture
Anomalous conjunction of biliary and pancreatic duct
