CAJ | 학술논문

目的探讨胰管结石伴发慢性胰腺炎急性发作的临床治疗方案.方法回顾性分析南华大学附属南华医院1998年1月至2006年9月收治的11例胰管结石伴发慢性胰腺炎急性发作病人的临床资料,11例均接受手术治疗,其中胰头部胰管切开加十二指肠乳头成形及胆总管切开T管引流术2例,胰管切开取石并胰管空肠Roux-en-Y吻合术5例,胰体尾切除加胰断端面胰管空肠Roux-en-Y吻合2例.单纯胰尾切除2例.结果术后疼痛治愈率54.54%(6/11),好转率45.45%(5/11),胰漏(瘘)或出血27.27%(3/11).9例平均随访时间(39.2±36.2)个月,均无并发症出现.结论胰管结石伴发慢性胰腺炎急性发作者早期宜非手术治疗,3个月后接受适宜的外科手术治疗,效果肯定.并发症发生率较低,术式根据结石部位、主胰管是否通畅决定.
목적 탐토이관결석반발만성이선염급성발작적림상치료방안.방법 회고성분석남화대학부속남화의원1998년1월지2006년9월수치적11례이관결석반발만성이선염급성발작병인적림상자료,11례균접수수술치료,기중이두부이관절개가십이지장유두성형급담총관절개T관인류술2례,이관절개취석병이관공장Roux-en-Y문합술5례,이체미절제가이단단면이관공장Roux-en-Y문합2례.단순이미절제2례.결과 술후동통치유솔54.54%(6/11),호전솔45.45%(5/11),이루(루)혹출혈27.27%(3/11).9례평균수방시간(39.2±36.2)개월,균무병발증출현.결론 이관결석반발만성이선염급성발작자조기의비수술치료,3개월후접수괄의적외과수술치료,효과긍정.병발증발생솔교저,술식근거결석부위、주이관시부통창결정.
Objective To explore the therapeutic scheme of pancreatic duct stones companying acute occurrence of chronic pancreatitis.Methods A total of 11 cases of pancreatic duct stones companying acute occurrence of chronic pancreatitis were surgically treated in our hospitaI from January 1998 tO September 2006.Of the 11 patients,2 were subjected tO pancreatico-lithotomy,duodenal papillotomy and hepatocholangiostomy,5 to pancreatico-lithotomy and pancreaticoiejunostomy,2 to resection of pancreatic tail with pancreaticojejunostomy and the other 2 to single resection of pancreatic tail.Results In general,the initial symptom of pancreatic duct stones companying acute occurrence of chronic pancreatitis was characterized by acute upper abdominal pain.B-mode ultrasonography and CT were important for its early diagnosis and ERCP was also of help to diagnosis.After operation,chronic abdominal pain disappeared in 54.54%(6/11)and ameliorated in 45.45%(5/11).Pancreatic fistula or bleeding occurred in 27.27%(3/11)of the patients.The follow-up of a mean of(39.2±36.2)months in 9 patients showed that there was no complication.Conclusion Pancreatic duct stones companying acute occurrence of chronic pancreatitis should be managed by conservative treatment in the early phase of disease.and correlative operation 3 months later.