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| 題 名 | 急性膽石性胰臟炎--較合理的治療方針 |
|---|---|
| 作 者 | 吳誠中; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 18:3 1985.09[民74.09] |
| 頁 次 | 頁288-294 |
| 分類號 | 416.248 |
| 關鍵詞 | 急性膽石性胰臟炎; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 急性膽石性胰臟炎的成因,至今仍未明;而手術治療膽石症的時機與手術式,亦迭有爭論。本文罔顧過去2年間,台中帶總一般外料,接受手術治療膽石性胰臟炎之35病例,做分析對象。依其手術之時機,分成兩組:第1組病人因有腹膜炎,膽道急症併發休克,或以內科支持療法無法改善臨床炎症症狀,而於住院後48小時以內接受手術者。第2組病人則先以內科療法,使胰臟炎之急性症狀消失後再手術。歸納其臨床結果為:(1)膽石性胰臟炎多伴隨不等程度的膽道感染。(2)第1組病人術中發現,術後水腫較厲害,術後併發症機會也較高。(3)第2組病人,多可實施較確定之膽道手術。(4)手術中發現膽石之位置,並存膽道感染機率,及總住院日數,兩組間無明顯差異。(5)胰臟炎的嚴重度,並非緊急手術之依據。 此35例並無死亡例。我們認為:不拘泥於某一手術時機,儘量做確定之膽道手術,以清除膽石,是治療急性膽石性胰臟炎較為合理的治療方針。 |
| 英文摘要 | The exact cause of gallstone pancreatitis is obscure, and the timing and extent of biliary surgery as treatment have also remained controversial. Thirty-five patients with acute gallstone pancreatitis who had been treated surgically in the Veterans Geheral Hospital Taichung during the past two years were collected for a retrospective analysis. Cases were divided into two groups: Group I included patients who received emergent biliary operations within 48 hours after admission due to peritonitis, severe biliary sepsis or intractability to medical treatment; Group II included those patients whose surgeries were delayed from 3 to 28 days until the acute abdominal condition subsided. No mortality, but a few cases of morbidity were found in our series. From the clinical results, it was concluded that: (1) Acute gallstone pancreatitis is always accompanied by biliary infections. (2) Greater possiblity of pancreatic edema and postoperative morbility was found in Group I patients who were, however, treatable. (3) Biliary surgery could be more definitively carried out in Group II patients. (4) There was no significant difference between the two Groups with regard to location of gallstones, frequency of concomitant biliary infection and duration of hospitalization. (5) An emergent mandatory operation did not necessarily depend on Ranson's risk signs which were used for estimating the severity of acute pancreatitis. Optimal timing of operation, definitive biliary surgery and being alert to concomitant biliary diseases are considered to be the most reasonable policy at present in treatment of acute gallstone pancreatitis. |
本系統中英文摘要資訊取自各篇刊載內容。