摘要
目的探讨胆囊结石伴急性胰腺炎的腹腔镜胆囊切除术（LC）的可行性及手术时机选择。方法回顾性分析行LC治疗胆囊结石伴急性胰腺炎42例的手术效果与安全性。结果42例LC均获成功，12例放置腹腔引流管，于术后24～72小时拔除；38例恢复颇利，2例术后3天又发作急性胰腺炎，经保守治疗后症状缓解；2例术后疼痛、黄疸，经ERCP、EST取出胆总管结石而治愈；住院5～28天，平均为13天；其中32例随访6个月～3年，均无胰腺炎。结论对胆囊结石伴急性胰腺炎患者应尽早行LC术以去除原发病因，MRCP是重要的检查项目，ERCP、EST是重要的辅助治疗与补救手段。
Objective To investigate the feasibility and the choice of the operational opportunity for treatment of cholecystolithiasis accompanied with acute pancreatitis by laparoscopic cholecystectomy （LC）. Methods A retrospective analysis was performed on the clinical materials of 42 patients with cholecystolithiasis accompanied by acute pancreatitis with LC. Resnlts 42 patients were successfully treated. In 12 of the 42 patients, the drainage tubes were placed in their abdominal cavities, which were pulled out 24-72 hours after the operations. Among the 42 patients, 38 recovered smoothly, 2 had a recurrence of acute pancreatitis 3 days after operation, but the symptoms were relieved after the conservative treatment, and 2 developed the postoperative pain and jaundice, which were successfully treated by the removal of the common duct stones by the endoscopic sphincterotomy （EST） with the help of endoscopic retrograde cho]angiopancreatography （ERCP）. The patients were hospitalized for 5-28 days averaged 13 days. Among the 42 patients, 32 were followed up for 0.5-3.0 years, and no acute pancreatitis was found again. Conclusions LC should be performed as soon as possible in treatment of patients with cholecystolithiasis accompanied by acute pancreatitis to eliminate the primary etiological factors. The magnetic resonance cholangiopancreatography （MRCP） is an important examination, and EST with the help of ELCP is an important adjunctive therapy.
出处
《西部医学》
2009年第6期969-970,共2页
Medical Journal of West China
关键词
胆囊结石伴急性胰腺炎
腹腔镜胆囊切除术
ERCP
EST
Cholecystolithiasis accompanied by acute pancreatitis
Laparoscopic cholecystectomy （LC）
Endoscopic retrograde cholangiopancreatography （ERCP）
Endoscopic sphincterotomy （EST）
