Objective:To explore the clinical efficacy and safety of laparoscope combined with duodenoscope in the treatment of patients with severe acute biliary pancreatitis (ABP).Methods:A total of 58 patients with ABP were randomly divided into observation group (n =28)treated with aparoscope combined with duodenoscope and control group (n =30)with conventional laparotomy.Surgical conditions,mortality rate and rate of complications were compared between two groups.Results:Patients of both groups finished the surgery completely and none died.In observation group,3 patients with difficulty of intubation due to duodenoscope,3 with incarcerated gallstones in papilla and 2 with residual lithiasis received secondary duodenoscope in selective days,while 8 were complicated with cho-ledocholithiasis.In control group,1 patient who had disease aggravation 3 d after operation was given surgical debridement drainage and 6 had residual lithiasis.The mortality rates of observation and control groups were 3.57% and 16.67%,respectively (P >0.05 ),and observation group was markedly shorter in hospital stays than control group (P <0.01 ).The rate of complications was 14.29% in ob-servation group,prominently lower than the 43.33% in control group (P <0.01 )Conclusion:Laparoscope combined with duodeno-scope is an ideal surgical method for patients with ABP,which can has lower mortality rate,reduce postoperative complications,promote disease recovery and shorten hospital stays.%目的：探讨腹腔镜联合十二指肠镜手术治疗急性重症胆源性胰腺炎（ABP）的疗效及安全性。方法：方法：58例 ABP 患者根据治疗方法分为观察组（n ＝28）行腹腔镜及十二指肠镜手术和对照组（n ＝30）行传统开腹手术，比较2组手术情况、病死率及并发症发生率。结果：2组均成功完成手术，术中无死亡病例。观察组3例因十二指肠镜术中插管困难，3例乳头部结石嵌顿，2例有残余结石，行第2次择期十二指肠镜手术，8例合并胆总管结石。对照组1例术后3 d 病情恶化，行手术清创引流，6例有残余结石。观察组和对照组病死率分别为3．57％和16．67％（P ＞0．05），观察组住院时间显著短于对照组（P ＜0．01）。观察组并发症发生率14．29％，显著低于对照组的43．33％（P ＜0．01）。结论：腹腔镜联合十二指肠镜手术治疗ABP 疗效较为理想，病死率低，术后并发症少，可促进病情康复，缩短住院时间。
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