胆石性胰腺炎内镜治疗。

Endoscopy in Gallstone Pancreatitis.

机构信息

Department of Gastroenterology & Hepatology, Erasmus University Medical Center, Doctor Molewaterplein 40, Rotterdam 3015 GD, the Netherlands.

出版信息

Gastrointest Endosc Clin N Am. 2023 Oct;33(4):701-707. doi: 10.1016/j.giec.2023.04.003. Epub 2023 May 16.

DOI:10.1016/j.giec.2023.04.003

PMID:37709405

Abstract

The root cause for biliary pancreatitis is a transient impediment of the outflow of secretion from the pancreatic duct due to gallstones and sludge obstructing the ampulla of Vater. Based on meta-analyses and recent studies, clear recommendations can be formulated when and when not to perform an ERC in patients with biliary pancreatitis. ERC is indicated urgently in patients with biliary pancreatitis and concomitant cholangitis. Urgent ERC is not indicated in patients with predicted mild or severe biliary pancreatitis without cholangitis, even when stones or sludge are proven on EUS imaging.

摘要

胆源性胰腺炎的根本原因是由于胆结石和淤泥阻塞 Vater 壶腹而导致胰管分泌排出的短暂受阻。基于荟萃分析和最近的研究，可以制定出在胆源性胰腺炎患者中何时进行和不进行内镜逆行胰胆管造影（ERCP）的明确建议。胆源性胰腺炎合并胆管炎的患者需要紧急进行 ERCP。对于预测为轻度或重度胆源性胰腺炎且无胆管炎的患者，即使在超声内镜检查中发现结石或淤泥，也不建议进行紧急 ERCP。