Wullstein C, Bechstein W O
Klinik für Allgemein- und Gefässchirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt,
Chirurg. 2004 Jun;75(6):641-51; quiz 652. doi: 10.1007/s00104-004-0888-7.
Acute pancreatitis is an acute inflammatory process of the pancreas mainly due to biliary obstruction or alcohol consumption. Most episodes of acute pancreatitis are mild and resolve under conservative treatment. Severe forms of acute pancreatitis, especially the necrotising form, still have a high mortality rate and can be difficult to treat. The problem today is to identify the few cases that should be treated operatively. Infected necroses are well accepted as an indication for operative treatment. Surgery consists of débridement and necrosectomy followed by closed or open lavage. In biliary pancreatitis, ERCP is performed early in cases of biliary obstruction, with or without cholangitis. In these patients cholecystectomy should be performed electively after clinical recovery.
急性胰腺炎是胰腺的一种急性炎症过程,主要由胆道梗阻或饮酒引起。大多数急性胰腺炎发作是轻度的,在保守治疗下可缓解。严重形式的急性胰腺炎,尤其是坏死性胰腺炎,死亡率仍然很高,且治疗困难。目前的问题是识别出少数需要手术治疗的病例。感染性坏死已被广泛接受为手术治疗的指征。手术包括清创和坏死组织切除术,随后进行闭式或开放式灌洗。在胆源性胰腺炎中,对于伴有或不伴有胆管炎的胆道梗阻病例,应早期进行内镜逆行胰胆管造影(ERCP)。在这些患者临床恢复后,应择期行胆囊切除术。