胆石症合并胰腺炎手术时机选择的探讨

摘要

目的：探讨胆石症合并胰腺炎手术时机的选择。方法回顾性分析90例胆石症合并胰腺炎患者的临床资料。结果52例患者经保守治疗2周后，行腹腔镜胆囊切除术(38例)或开腹胆囊切除术(14例)。8例合并梗阻性黄疸较重行急诊开腹手术，胆道镜取石， T管引流；其余30例保守治疗3个月后，再次入院行腹腔镜下胆囊切除术。全部患者均痊愈出院。结论胆石症合并胰腺炎伴有严重梗阻性黄疸的患者宜早期手术解除梗阻。而对于胰腺周围渗出较少的患者，可以保守治疗，待稳定后择期手术，效果良好。%Objective To explore the time of surgery about gallstone combine pancreatitis. Methods Retrospective analyzed clinical data of 90 patients with gallstone combine pancreatitis. Results After two weeks of conservative treatment, 52 patients accepted laparoscopic cholecystectomy(38 cases) or open cholecystectomy(14 cases). 8 cases combined with severe obstructive jaundice underwent emergency laparotomy choledochoscopic stone, T-tube drainage.The remaining 30 cases conservative treatment three months later, readmitted under laparoscopic cholecystectomy. All patients were cured. Conclusion Combined with severe gallstone pancreatitis in patients with obstructive jaundice advised early surgery to remove the obstruction. For oozing around the pancreas fewer patients can be treated conservatively, to be stable elective surgery with good Results.