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急性胆源性胰腺炎:诊断与治疗

Acute biliary pancreatitis: diagnosis and treatment.

作者信息

Hazem Zakaria M

机构信息

Department of Surgery, College of Medicine, King Faisal University, Dammam, Kingdom of Saudi Arabia, Al-Khobar - 31952.

出版信息

Saudi J Gastroenterol. 2009 Jul-Sep;15(3):147-55. doi: 10.4103/1319-3767.54740.

Abstract

Gallstones are the commonest cause of acute pancreatitis (AP), a potentially life-threatening condition, worldwide. The pathogenesis of acute pancreatitis has not been fully understood. Laboratory and radiological investigations are critical for diagnosis as well prognosis prediction. Scoring systems based on radiological findings and serologic inflammatory markers have been proposed as better predictors of disease severity. Early endoscopic retrograde cholangiopancreatography (ERCP) is beneficial in a group of patients with gallstone pancreatitis. Laparoscopic cholecystectomy with preoperative endoscopic common bile duct clearance is recommended as a treatment of choice for acute biliary pancreatitis. The timing of cholecystectomy, following ERCP, for biliary pancreatitis can vary markedly depending on the severity of pancreatitis.

摘要

胆结石是全球范围内急性胰腺炎(AP)最常见的病因,急性胰腺炎是一种可能危及生命的疾病。急性胰腺炎的发病机制尚未完全明确。实验室检查和影像学检查对于诊断以及预后预测至关重要。基于影像学表现和血清学炎症标志物的评分系统已被提出,作为疾病严重程度更好的预测指标。早期内镜逆行胰胆管造影术(ERCP)对一组胆结石性胰腺炎患者有益。推荐采用术前内镜清除胆总管结石的腹腔镜胆囊切除术作为急性胆源性胰腺炎的首选治疗方法。对于胆源性胰腺炎,在ERCP之后进行胆囊切除术的时机,会因胰腺炎的严重程度而有显著差异。

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