目的：观察ERCP对腹腔镜胆囊切除术(laparoscopic cholecystectomy LC)后出现急性胰腺炎(acute pancreatitis AP)的早期治疗效果。方法：收集2005年6月至2013年12月47例AP患者(均是胆囊结石腹腔镜胆囊切除术后)，所有患者住院行ERCP + EST治疗，术中放置鼻胆管(Endoscopic naso-biliary drainage, ENBD)9例，胆管支架4例。结果：术中发现胆总管结石36例，9例胆总管下端狭窄，2例胆总管下端恶性肿瘤。术后未出现十二指肠穿孔、胰腺炎加重等严重并发症。结论：胆道因素依然是LC术后急性胰腺炎的首要因素，ERCP治疗腹腔镜胆囊切除术后急性胰腺炎有显著疗效。 Objective: To investigate the value of endoscopic retrograde cholangiopancreatitis (ERCP) in early diagnosis and treatment of acute pancreatitis after laparoscopic cholecystectomy (LC). Methods: The data of 47 cases with acute pancreatitis after LC in our hospital from June 2005 to December 2013 were retrospectively analyzed. All cases were treated with ERCP + EST, 9 cases were cured with ENBD, 4 cases were placed stent. Result: 36 cases were choledocholithiasis, 9 cases were common bile duct stricture, 2 cases were maligment, and there was no severe complication after ERCP, such as gastroduodenal perforation. Conclusion: The major cause of acute pancreatitis after LC was biliary factor. For these cases, the treatment by ERCP was safe and effective.
Working Party of the British Society of Gastroenterology, Association of Surgeons of Great Britain and Ireland, Pan- creatic Society of Great Britain and Ireland (2005) UK guidelines for the management of acute pancreatitis. Gut, 54, 1-9.
