临床研究(Clinical Research)

序贯微创治疗急性胆源性胰腺炎:附112例报告

Published at: 2016年第25卷第9期

李军 1 , 谢江 1 , 廖作富 1 , 余阳 1 , 陈中浩 1
1 上海交通大学医学院附属同仁医院 普通外科,上海 200336
通讯作者 中浩 陈 Email: upinarm@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.09.013
基金:

摘要

目的:探讨序贯微创治疗急性胆源性胰腺炎(ABP)的疗效。方法:对2013年1月—2015年12月112例ABP患者行保守治疗基础上的序贯微创治疗,后者包括内窥镜下鼻胆管引流(ENBD)后内镜下乳头括约肌切开术(EST)+网篮取石,择期行腹腔镜胆囊切除术(LC)或LC+胆总管切开取石(LCBDE)以及微创治疗的基础上的个体化治疗。结果: 88例轻、中型患者均在住院期间解除胆道结石病因并痊愈出院,无死亡病例,平均住院(7.5±2.3)d;24例重型患者中,2例因多器官功能衰竭死亡,其余均顺利出院,平均住院(21.2±5.3)d。结论:序贯微创治疗ABP疗效确切,具有住院期间一次彻底解除病因,缩短平均住院时间等优势。


Staged sequential minimally invasive approach for acute biliary pancreatitis: a report of 112 cases

Abstract

Objective: To investigate the efficacy of staged sequential minimally invasive approach for acute biliary pancreatitis (ABP). Methods: From January 2013 to December 2015, 112 patients with ABP received basic conservative treatment together with staged sequential minimally invasive management, which included endoscopic nasobiliary drainage (ENBD) followed by endoscopic sphincterotomy (EST) plus basket stone extraction, and then, elective laparoscopic cholecystectomy (LC) or LC plus laparoscopic common bile duct exploration (LCBDE), and individualized treatment based on minimally invasive therapy. Results: In all 88 patients with mild or moderate disease, the etiologic biliary stones were extracted during hospitalization, and they were cured and discharged from hospital with no mortality and an average length of hospital stay of (7.5±2.3) d; in the 24 patients with severe disease, 2 cases died of multi-organ failure, and the remaining cases were cured and discharged from hospital uneventfully, with an average length of hospital stay of (21.2±5.3) d. Conclusion: Staged sequential minimally invasive method has definite efficacy in treatment of ABP, with advantages of thorough resolution of the cause of disease during one-admission and reduced length of hospitalization.


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引用

引用本文: 军 李, 江 谢, 作富 廖, 阳 余, 中浩 陈. 序贯微创治疗急性胆源性胰腺炎:附112例报告[J]. 中国普通外科杂志, 2016, 25(9): 1302-1306.
Cite this article as: LI Jun, XIE Jiang, LIAO Zuofu, YU Yang, CHEN Zhonghao . Staged sequential minimally invasive approach for acute biliary pancreatitis: a report of 112 cases [J]. Chin J Gen Surg, 2016, 25(9): 1302-1306.