Carr-Locke D L
Brigham and Women's Hospital, Boston, Massachusett, USA.
Ann Ital Chir. 1995 Mar-Apr;66(2):203-7.
The successes of supportive management of patients with severe acute pancreatitis in recent years has evolved from our improved understanding of some of the serious consequences of pancreatic necrosis on other organ systems. When gallstone disease is identified as the cause in such patients, there has been an expectation that biliary intervention will lead to a more rapid resolution of the index attack and prevention of future pancreatitis. There is now convincing evidence, in the setting of severe gallstone-associated pancreatitis using prognostic scoring, that not only is emergency or early elective biliary surgery associated with an unacceptable morbidity and mortality but that appropriate endoscopic therapy is safe and highly effective. In populations where concomitant cholangitis is common, emergency biliary endoscopic management provides optimal therapy for all grades of pancreatitis.
近年来，重症急性胰腺炎患者支持治疗的成功源于我们对胰腺坏死对其他器官系统一些严重后果的深入理解。当胆结石疾病被确定为此类患者的病因时，人们期望胆道干预能使首发发作更快缓解，并预防未来的胰腺炎。现在有令人信服的证据表明，在使用预后评分的重症胆结石相关性胰腺炎的情况下，不仅急诊或早期择期胆道手术的发病率和死亡率令人难以接受，而且适当的内镜治疗是安全且高效的。在合并胆管炎常见的人群中，急诊胆道内镜治疗为所有级别的胰腺炎提供了最佳治疗方法。
