Mercer L C, Saltzstein E C, Peacock J B, Dougherty S H
Am J Surg. 1984 Dec;148(6):749-53. doi: 10.1016/0002-9610(84)90430-6.
Herein, we documented our successful experience in performing definitive biliary tract surgery on patients with biliary pancreatitis as soon as the diagnosis was made and within 48 hours of admission. Early surgery reduced the length of hospital stay and did not result in associated morbidity, death, or complications of acute pancreatitis. The results of the study support the concept that removing obstruction of the pancreatic duct prevents progression of edematous pancreatitis to hemorrhagic pancreatitis. We conclude that patients with acute pancreatitis should be evaluated urgently for the presence of biliary tract stone disease and should be operated on as soon as the diagnosis of biliary pancreatitis is made, that early definitive surgery can be performed safely on patients with biliary pancreatitis, that cholecystectomy with intraoperative cholangiography and common duct exploration as necessary should be performed in all patients, and that length of stay for patients with biliary pancreatitis is reduced and morbidity and mortality possibly may be reduced by early surgery as compared with delayed surgery.
在此,我们记录了我们在确诊后且入院48小时内对胆源性胰腺炎患者进行确定性胆道手术的成功经验。早期手术缩短了住院时间,且未导致急性胰腺炎相关的发病率、死亡率或并发症。该研究结果支持这样的概念,即解除胰管梗阻可防止水肿性胰腺炎发展为出血性胰腺炎。我们得出结论,急性胰腺炎患者应紧急评估是否存在胆道结石病,一旦确诊为胆源性胰腺炎就应尽快手术;早期确定性手术可安全地用于胆源性胰腺炎患者;所有患者均应进行胆囊切除术,并根据需要进行术中胆管造影和胆总管探查;与延迟手术相比,早期手术可缩短胆源性胰腺炎患者的住院时间,并可能降低发病率和死亡率。