Department of Surgical Oncology and Gastroenterological Surgery, Sapporo Medical University School of Medicine, Minami 1, Nishi 16, Chuo-ku, Sapporo, 060-8543, Japan.
J Hepatobiliary Pancreat Sci. 2010 Jan;17(1):60-9. doi: 10.1007/s00534-009-0217-0. Epub 2009 Dec 11.
In the care of acute pancreatitis, a prompt search for the etiologic condition of the disease should be conducted. A differentiation of gallstone-induced acute pancreatitis should be given top priority in its etiologic diagnosis because it is related to the decision of treatment policy. Examinations necessary for diagnosing gallstone-induced acute pancreatitis include blood tests and ultrasonography. Early ERCP/ES should be performed in patients with gallstone-induced acute pancreatitis if a complication of cholangitis and a prolonged passage disorder of the biliary tract are suspected. The treatment for bile duct stones with the use of ERCP/ES alone is not recommended in cases of gallstone-induced pancreatitis with gallbladder stones. Cholecystectomy for gallstone-induced acute pancreatitis should be performed using a laparoscopic procedure as the first option as soon as the disease has subsided.
在急性胰腺炎的治疗中,应迅速寻找病因。病因诊断中应优先考虑胆石症引起的急性胰腺炎,因为这与治疗策略的决定有关。诊断胆石症引起的急性胰腺炎所需的检查包括血液检查和超声检查。如果怀疑胆石症引起的急性胰腺炎患者有胆管炎和胆道长时间梗阻的并发症,应早期进行 ERCP/ES。对于有胆囊结石的胆石症引起的胰腺炎,不建议单独使用 ERCP/ES 治疗胆管结石。一旦疾病缓解,应尽快采用腹腔镜手术进行胆囊切除术。
J Hepatobiliary Pancreat Sci. 2009-12-11
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