Ell C
Medizinische Universitätsklinik I, Friedrich-Alexander-Universität Erlangen-Nürnberg.
Schweiz Med Wochenschr. 1993 May 29;123(21):1074-8.
Gallstones are the most important causes of acute pancreatitis. Endoscopic-retrograde cholangiography (ERC) is indicated in all situations of acute pancreatitis where the cholestatic enzymes are elevated, the common bile duct is dilated or stones or sludge are detected in the gallbladder sonographically. Additional indications are cholecystectomized patients and where there is no evidence of heavy alcohol ingestion. If common bile duct stones are detected by ERC, endoscopic sphincterotomy is the treatment of choice. In severe cases of biliary pancreatitis in particular, endoscopic therapy improves the final outcome and reduces morbidity and mortality rates. The more severe the clinical situation, the earlier endoscopic therapy should be performed.
胆结石是急性胰腺炎的最重要病因。在急性胰腺炎的所有情况下,若胆汁淤积酶升高、胆总管扩张或超声检查发现胆囊内有结石或胆泥,均需进行内镜逆行胆管造影(ERC)。其他指征包括胆囊已切除的患者以及无大量饮酒证据的患者。如果通过ERC检测到胆总管结石,内镜括约肌切开术是首选治疗方法。特别是在重症胆源性胰腺炎中,内镜治疗可改善最终结局并降低发病率和死亡率。临床情况越严重,内镜治疗就应越早进行。