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妊娠期急性重症胰腺炎后胆囊切除术的时机

Timing of cholecystectomy after acute severe pancreatitis in pregnancy.

作者信息

Talebi-Bakhshayesh Mousa, Mohammadzadeh Alireza, Zargar Ali

机构信息

Velayat Clinical Research Development Unit, Velayat Hospital, Qazvin University of Medical Sciences, Shahid Bahonar Ave, 3419759811 Qazvin, Iran.

出版信息

Malays J Med Sci. 2015 May-Jun;22(3):68-70.

Abstract

Acute pancreatitis is one of the most common diseases of the gastrointestinal tract and is usually caused by gallstones; its occurrence in pregnancy is rare. Cholecystectomy for biliary pancreatitis during pregnancy is unavoidable, but its timing is controversial. We herein present the case of a patient who underwent termination of pregnancy due to deteriorated acute severe pancreatitis during the 27th week of gestation. Cholecystectomy was performed because of the relapse of acute biliary pancreatitis 10 days after being discharged. The interval from pancreatitis to cholecystectomy varies with its severity; in mild pancreatitis the interval may be one week, but in severe cases it maybe up to three weeks. Because pancreatitis may relapse during this interval, as occurred in the present case, a better solution for the timing of cholecystectomy must be sought.

摘要

急性胰腺炎是胃肠道最常见的疾病之一,通常由胆结石引起;其在妊娠期的发生较为罕见。妊娠期因胆源性胰腺炎而行胆囊切除术不可避免,但其时机存在争议。我们在此报告一例患者,该患者在妊娠27周时因急性重症胰腺炎病情恶化而终止妊娠。出院10天后因急性胆源性胰腺炎复发而进行了胆囊切除术。从胰腺炎发作到进行胆囊切除术的间隔时间因其严重程度而异;轻度胰腺炎的间隔时间可能为一周,但在严重病例中可能长达三周。由于在此间隔期间胰腺炎可能复发,如本病例所示,必须寻求更好的胆囊切除术时机解决方案。

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American College of Gastroenterology guideline: management of acute pancreatitis.美国胃肠病学会指南:急性胰腺炎的管理。
Am J Gastroenterol. 2013 Sep;108(9):1400-15; 1416. doi: 10.1038/ajg.2013.218. Epub 2013 Jul 30.
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Clinical study on acute pancreatitis in pregnancy in 26 cases.26 例妊娠合并急性胰腺炎的临床研究。
Gastroenterol Res Pract. 2012;2012:271925. doi: 10.1155/2012/271925. Epub 2012 Nov 18.
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Acute pancreatitis in pregnancy: an overview.妊娠合并急性胰腺炎:概述。
Eur J Obstet Gynecol Reprod Biol. 2011 Dec;159(2):261-6. doi: 10.1016/j.ejogrb.2011.07.037. Epub 2011 Aug 12.

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