van der Spuy S
Department of Surgery, Provincial Hospital, Port Elizabeth, CP.
S Afr Med J. 1991 Jan 5;79(1):16-8.
An approach to suspected gallstone pancreatitis based on endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) was adopted in 1976 and was followed in 29 patients. ERCP became the routine method of early biliary tract assessment when gallstone pancreatitis was suspected on clinical and biochemical grounds, and further management was based on ERCP findings. If calculi were detected in the common bile duct (13 cases) ES was performed; when calculi were confined to the gallbladder (12 cases) cholecystectomy was advised; and if no calculi were detected on ERCP (4 cases) investigations were continued. ERCP proved to be a reliable guide to management, while ES provided safe and effective symptomatic relief when choledocholithiasis was present, and prevented recurrence of pancreatitis even when the gallbladder remained in situ.
1976年采用了一种基于内镜逆行胰胆管造影术（ERCP）和内镜括约肌切开术（ES）来处理疑似胆石性胰腺炎的方法，并应用于29例患者。当根据临床和生化表现怀疑为胆石性胰腺炎时，ERCP成为早期胆道评估的常规方法，进一步的处理则基于ERCP的检查结果。如果在胆总管发现结石（13例），则进行内镜括约肌切开术；当结石局限于胆囊（12例）时，建议行胆囊切除术；如果ERCP未发现结石（4例），则继续进行检查。事实证明，ERCP是处理的可靠指导，而内镜括约肌切开术在存在胆总管结石时能提供安全有效的症状缓解，即使胆囊仍保留原位，也可预防胰腺炎复发。
