摘要
探讨急性胆石性胰腺炎诊断和手术治疗的经验。方法回顾性分析45例行手术治疗的急性胆石性胰腺炎病人的临床资料和治疗结果。结果术前B超检查在发病24小时内施行的21例中9例显示胆总管结石，而发病超过24小时的24例中仅显示3例（P＜0．025）。本组手术包括单纯胆囊切除术33例，合并胆总管切开探查9例，合并胆总管探查和胰周引流3例。4例病人发生术后并发症（8．9％），仅1例手术死亡，术后第5天死于呼吸衰竭，术后死亡率与胆石性胰腺炎的严重性高度相关（P＜0．05）。结论①发病后B超检查越早，胆总管结石率越高。②手术死亡率与胆石性胰腺炎的严重性有显著相关性。③手术应在胰腺炎消退后首次住院期内施行。
Objective: To eva1uate our experience on the diagnosis and Surgical treatment of acute gallstone pancreatitis. Meh-ods The clinical data and therapeutic outcome of 45 cases of acute gallstone pancreatitis undergoing operation during the past lOyears were reviewed. Results Before operation,common bile duct stones were detected in 9 of 21 patients by ultras0n0graphy with-in 24 hours of the onset of the symptons compared with 3 of 24 patient exceeding those hours (P<0. O25 ). Operations in the currentseries included cholecystectomy alone (n = 33 ),cholecystectomy plus choledochus exploration (n = 9 ),peripancreatic drainage in addi-tion t0 cholecystectorny plus ch0ledochus exploration (n= 3). Postoperative complications 0ccurred in 4 patients (8. 9 M )- A singleone of postoperative death occurred on the 5th postoperative day due to respiratary failure. The postoperative rnortality rate wassignificantly associated with severity of gallstone pancreatitis (P<0. 005). Conculsions We reached the folIowing conclusions: ①The more early ultrasonography examination is done after the attack,the higher the stone rate of common bile duct is achieved. ②The operative mortality rate is highly related with severity of gallst0ne pancreatitis. ③Surgery shou1d be perforrned during the ini-tial admission after the pancreatitis has subsided.
出处
《肝胆外科杂志》
1998年第6期361-363,共3页
Journal of Hepatobiliary Surgery
