Bjerkeset Tormod, Skreden Knut, Edna Tom-Harald, Tøndel Hanne
Kirurgisk Avdeling Sykehuset Levanger 7600 Levanger.
Tidsskr Nor Laegeforen. 2002 Mar 10;122(7):688-90.
On the basis of a 19-year material we discuss early or delayed surgery for definitive clearance of the biliary tract after acute gallstone pancreatitis.
During 1980-98, 218 patients, 133 women and 85 men, median age 69.5 years (16-96 years) with acute gallstone pancreatitis were treated at Levanger hospital, Norway. During 1980-89 (period 1), 111 patients were mainly treated by open operations as soon as the acute pancreatitis had settled, while during 1990-98 (period 2), 107 patients were mainly treated conservatively and the biliary operations performed laparoscopically/endoscopically later.
In period 1 two patients died, one of them after open surgery (2%). In period 2 four patients died. 21 patients were readmitted due to a new attack, two of whom died. Two patients developed acute cholecystitis.
Early surgery for the gallstone disease in patients with acute gallstone pancreatitis is well tolerated, recurrent attacks are rare and the mortality low.
基于19年的资料，我们探讨急性胆石性胰腺炎后早期或延迟手术以彻底清除胆道。
1980年至1998年期间，挪威勒旺厄尔医院治疗了218例急性胆石性胰腺炎患者，其中女性133例，男性85例，年龄中位数为69.5岁（16至96岁）。1980年至1989年（第1阶段），111例患者在急性胰腺炎病情稳定后主要接受开放手术治疗；而在1990年至1998年（第2阶段），107例患者主要接受保守治疗，后期行腹腔镜/内镜下胆道手术。
第1阶段有2例患者死亡，其中1例死于开放手术后（2%）。第2阶段有4例患者死亡。21例患者因再次发作而再次入院，其中2例死亡。2例患者发生急性胆囊炎。
急性胆石性胰腺炎患者早期进行胆石病手术耐受性良好，复发罕见，死亡率低。
