Carr-Locke D L
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Am J Surg. 1993 Apr;165(4):519-21. doi: 10.1016/s0002-9610(05)80953-5.
Early identification of those patients presenting with acute pancreatitis due to gallstone disease is important since emergency intervention may prevent the development of local and systemic complications. Urgent biliary surgery carries unacceptably high morbidity and mortality rates, but endoscopic retrograde cholangiopancreatography in experienced centers appears to be safe and is the optimal method for the diagnosis of bile duct stones. Two randomized controlled prospective trials have shown an advantage for endoscopic sphincterotomy and bile duct clearance compared with supportive therapy when performed within 24 to 72 hours of admission in those patients whose symptoms are considered severe according to prognostic scoring systems.
早期识别那些因胆结石疾病而出现急性胰腺炎的患者很重要，因为紧急干预可能会预防局部和全身并发症的发生。紧急胆道手术的发病率和死亡率高得令人难以接受，但在经验丰富的中心进行内镜逆行胰胆管造影似乎是安全的，并且是诊断胆管结石的最佳方法。两项随机对照前瞻性试验表明，对于那些根据预后评分系统被认为症状严重的患者，在入院后24至72小时内进行内镜括约肌切开术和胆管清理术比支持性治疗更具优势。
