急性胆源性胰腺炎的手术治疗
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【摘要】 目的 探讨急性胆源性胰腺炎(ABP)的手术时机和手术治疗方式。方法 回顾分析112例ABP的临床资料。结果 23例急诊手术,分别进行了内镜下Oddi括约肌切开取石+腹腔镜胆囊切除术、胆道探查+胰腺包膜切开引流,发生并发症5例,死亡2例。89例延期手术,分别进行了腹腔镜胆囊切除术、开腹胆囊切除术、胆囊切除术+胆总管探查、胆囊切除+胆总管探查+左肝外叶切除、胆囊切除+胰腺假性囊肿内引流术,未发生严重并发症。结论 ABP首选非手术治疗,延期手术较急症手术有更大的安全性。
【关键词】 胰腺炎;胆源性;外科治疗
Surgical treatment ofacute biliary pancreatitis
XIONG Da-fu,GUAN Xiao-dong.Department of the Second Surgery,the Zhuhai Second People’s Hospital,Guangzhou 519000,China
【Abstract】 Objective To investigate the the timing of operation and surgical treatment of ABP. Methods The clinical data of 112 cases of ABP were retrospectively analyzed. Results 23 patients underwent emergency operation, they received endoscopic sphincterotomy(EST)+laparoscopic cholecystectomy,exploration of common bile duct+ capsula pancreatis incision and drainage, 5 cases had complications and 4 cases died. 89 patients underwent delayed operation, they received laparoscopic cholecystectomy(LC),open cholecystectomy, cholecystectomy+ exploration of common bile duct, cholecystectomy+ exploration of common bile duct+hepatectomy for left lateral, cholecystectomy+pancreatic pseudocyst internal drainage and no severe complications were observed ......
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