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急性胆源性胰腺炎:尼泊尔一家三级医院的经验

Acute biliary pancreatitis: an experience in a tertiary level hospital of Nepal.

作者信息

Manandhar Sujan, Giri Smith, Poudel Prakash, Bhandari Ramesh Singh, Lakhey Paleswan Joshi, Vaidya Pradeep

机构信息

Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

出版信息

Indian J Surg. 2013 Dec;75(6):449-53. doi: 10.1007/s12262-012-0533-5. Epub 2012 Jun 8.

Abstract

Acute Biliary Pancreatitis is one of the commonest forms of pancreatitis in Nepal. Controversies exist as to the most appropriate way of management of these cases. The present study was carried out to evaluate the management and outcome of Acute Biliary Pancreatitis cases in a tertiary level hospital of Nepal. A retrospective analysis of the patients managed with Acute Biliary Pancreatits was done. All patients admitted with the diagnosis of Acute Biliary Pancreatitis over a period of 2 years were included in the study. The variables measured were age, sex, clinical presentation, laboratory investigations, mode of treatment and outcome. A total of 45 cases had Acute Biliary Pancreatitis suggesting a prevalence of 28 %. The mean age was 45 ± 10 year. 39 patients (86.6 %) were treated with conservative management. 23 patients (54 %) had an uneventful recovery without any complications. 21 patients (46 %) developed some form of complications but recovered successfully. Mortality was seen in only one patient in the conservatively treated group. In a resource poor setting such as Nepal, definitive management is not always possible. Conservative management of Acute Biliary Pancreatitis has a favorable outcome in the majority of our patients with acceptable morbidity and mortality. Definitive management can be safely performed during index admission where possible.

摘要

急性胆源性胰腺炎是尼泊尔最常见的胰腺炎类型之一。对于这些病例的最恰当管理方式存在争议。本研究旨在评估尼泊尔一家三级医院中急性胆源性胰腺炎病例的管理情况及预后。对接受急性胆源性胰腺炎治疗的患者进行了回顾性分析。研究纳入了在2年期间内所有诊断为急性胆源性胰腺炎而入院的患者。所测量的变量包括年龄、性别、临床表现、实验室检查、治疗方式及预后。共有45例急性胆源性胰腺炎病例,患病率为28%。平均年龄为45±10岁。39例患者(86.6%)接受了保守治疗。23例患者(54%)顺利康复,无任何并发症。21例患者(46%)出现了某种形式的并发症,但成功康复。在保守治疗组中仅1例患者死亡。在像尼泊尔这样资源匮乏的环境中,并非总能进行确定性治疗。急性胆源性胰腺炎的保守治疗在我们大多数患者中具有良好的预后,发病率和死亡率均可接受。在可能的情况下,可在首次入院期间安全地进行确定性治疗。

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