目的：探讨急性胆源性胰腺炎非外科手术治疗的最佳方案。方法将180例急性胆源性胰腺炎患者按病情分为重症组86例和轻症组94例。以上患者再分成两组，分别予以早期内镜治疗和保守治疗。比较4组患者治疗后症状缓解天数、血清淀粉酶恢复时间、并发症发生率、死亡率及住院天数等指标。结果与重症保守治疗组相比，重症内镜治疗组白细胞、血淀粉酶、尿淀粉酶、肝功能、腹痛恢复时间及住院时间明显缩短，并发症发生率降低（ P＜0.05）；而轻症内镜治疗组与轻症保守治疗组各项观察指标比较差异无统计学意义（ P＞0.05）。结论重症急性胆源性胰腺炎应早期行内镜治疗，而轻症急性胆源性胰腺炎根据具体病情可以选择内科保守治疗或者内镜治疗。%Objective To search the best way of non-surgical treatments for acute biliary pancreatitis (ABP).Methods One hundred and eighty patients with ABP were divided into severe ABP group (n =86) and mild ABP group (n =94).The two groups were further divided into two subgroups .The patients were treated with early endoscopic therapy and conservative treatment ,respective-ly.The number of days of symptom remission ,serum amylase recovery time ,incidence of complications ,mortality,length of stay in hospi-tal and other indicators were compared among the groups .Results Compared with the severe conservative treatment subgroup , white blood cells,serum amylase,and urine amylase,liver function,abdominal pain recovery time and hospitalization time were significantly shorter,and the incidence of complications was lower in the severe endoscopic treatment group (P<0.05).However,there was no sig-nificant difference in those observed indexes between the mild endoscopic therapy subgroup and the mild conservative treatment group (P >0.05).Conclusion Severe acute biliary pancreatitis should be treated early with endoscopic therapy while mild acute biliary pancreatitis can be treated with either conservative or endoscopic therapy according to the detailed illness .
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