Clinical Research on Endoscopic Therapy for Acute Biliary Pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Jian ¹ , DU Bo ¹ , HU Bing ² , XIE Zhihua ³ , DAN Jie ¹ , ZHONG Xianfei ³

1.The First Department of Surgery, People’s Hospital of Leshan City, Leshan 614000, Sichuan Province, China;;
2.Center of Endoscope, West China Hospital, Sichuan University, Chengdu 610041, China;;
3.The First Department of Internal Medicine, People’s Hospital of Leshan City, Leshan 614000, Sichuan Province, China;

Corresponding author：

Keywords：

Endoscopic retrograde cholangiopancreatography; Acute biliary pancreatitis; Effect

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Objective To evaluate the safety and effect of early therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and interventional treatment for acute biliary pancreatitis.
Methods Eighty-seven hospitalized patients with acute biliary pancreatitis were divided into endoscopic therapy group and conservative therapy group according to the treatment methods. ERCP examination and treatment were used in the endoscopic therapy group, medical conservative treatments were used in the conservative therapy group. The efficacy such as blood amylase recovery time, abdominal pain relief time, blood white blood cell recovery time, liver function recovery time, hospital stay, and complications were observed. Results Blood amylase recovery time, abdominal pain relief time, blood white blood cell recovery time, liver function recovery time, and hospital stay in the endoscopic therapy group were significantly shorter than those in the conservative therapy group (P lt;0.05). There were no ERCP related severe complications or aggrevated symptoms.
Conclusion Early endoscopic therapy is a safe and effective method for acute biliary pancreatitis and can prevent further progression to severe status.

Citation： WANG Jian ,DU Bo,HU Bing,XIE Zhihua,DAN Jie,ZHONG Xianfei. Clinical Research on Endoscopic Therapy for Acute Biliary Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(9): 970-973. doi: Copy

1.	Schietroma M, Lattanzio R, Risetti A, et al. Diagnosis of severity as a basic parameter in the treatment of acute biliary pancreatitis [J]. Minerva Chir, 2000; 55(6): 421429.
2.	Uomo G, Slavin J. Endoscopic sphincterotomy for acute pancreatitis: arguments in favour [J]. Ital J Gastroenterol Hepatol, 1998; 30(5): 557561.
3.	中华医学会消化病学分会胰腺疾病学组. 中国急性胰腺炎诊治指南(草案) [J]. 中华内科杂志, 2004; 43(3): 236238.
4.	Cohen S, Bacon BR, Berlin JA, et al. National Institutes of Health StateoftheScience Conference Statement: ERCP for diagnosis and therapy, January 1416, 2002 [J]. Gastrointest Endosc, 2002; 56(6): 803809.
5.	Working Party of the British Society of Gastroenterology; Association of Surgeons of Great Britain and Ireland; Pancreatic Society of Great Britain and Ireland; Association of Upper GI Surgeons of Great Britain and Ireland. UK guidelines for the management of acute pancreatitis [J]. Gut, 2005; 54(Suppl Ⅲ): Ⅲ1Ⅲ19.
6.	中华医学会消化病学分会胰腺疾病学组. 中国急性胰腺炎诊治指南(草案) [J]. 中华消化杂志, 2004; 24(3): 190192.
7.	张志功, 朱化刚, 孟翔凌, 等. APACHEⅡ、RANSON 评分在重症急性胰腺炎中的应用价值 [J]. 肝胆外科杂志, 2005; 13(1): 3235.
8.	孙明. 内科治疗学 [M]. 第12版. 北京: 人民卫生出版社, 2006: 352354.
9.	郑芝田. 胃肠病学 [M]. 北京：人民卫生出版社, 2000: 13781379.
10.	Forsmark CE. The clinical problem of biliary acute necrotizing pancreatitis: epidemiology, pathophysiology, and diagnosis of biliary necrotizing pancreatitis [J]. J Gastrointest Surg, 2001; 5(3): 235239.
11.	van Brummelen SE, Venneman NG, van Erpecum KJ, et al. Acute idiopathic pancreatitis: does it really exist or is it a myth? [J]. Scand J Gastroenterol Suppl, 2003; (239): 117122.
12.	Kaiser AM, Saluja AK, Steer ML. Repetitive shortterm obstructions of the common bilepancreatic duct induce severe acute pancreatitis in the opossum [J]. Dig Dis Sci, 1999; 44(8): 16531661.
13.	张肇达, 田伯乐. 急性胆源性胰腺炎 [J]. 中华肝胆外科杂志, 2002; 8(2): 93.
14.	李学谦, 江堤, 顾红祥, 等. ERCP相关技术治疗胰胆道疾病219例临床分析 [J]. 赣南医学院学报, 2008; 28(4): 520521.
15.	Pezzilli R, Billi P, MorselliLabate AM, et al. Anesthesiological risk and endoscopic sphincterotomy in acute biliary pancreatitis [J]. Pancreas, 2003; 26(4): 334338.
16.	袁耀宗. 胰腺病学新进展与新技术 [M]. 上海：上海科学技术文献出版社， 2001: 324325.
17.	Schietroma M, Carlei F, Lezoche E, et al. Acute biliary pancreatitis: staging and management [J]. Hepatogastroenterology, 2001; 48(40): 988993.
18.	李兆申. 胆胰疾病的内镜治疗 [J]. 中国实用外科杂志, 2005; 25(6): 326328.
19.	万伟, 吴小鹏, 唐艳. LC术联合EST术治疗胆囊及胆总管结石12例 [J]. 中国现代普通外科进展, 2005; 8(3): 156.
20.	Arnold JC, Benz C, Martin WR, et al. Endoscopic papillary balloon dilation vs. sphincterotomy for removal of common bile duct stones: a prospective randomized pilot study [J]. Endoscopy, 2001; 33(7): 563567.
21.	李兆申. 积极开展急性胆源性胰腺炎的内镜治疗 [J]. 胰腺病学, 2002; 2(2): 6567.
22.	张奇, 孙备. 梗阻型胆源性胰腺炎内镜治疗时机的选择 [J]. 中国普通外科杂志, 2008; 17(3): 203206.
23.	张圣道, 雷若庆. 国际胰腺病学会《急性胰腺炎外科处理指南》介绍及相关讨论 [J]. 肝胆胰外科杂志, 2003; 15(2): 133134.
24.	于澜, 姚欣敏, 胡先典, 等. 经内镜治疗急性胆源性胰腺炎30例报道 [J]. 中国普外基础与临床杂志， 2007; 14(4): 396398.
25.	Fan ST, Lai EC, Mok FP, et al. Early treatment of acute biliary pancreatitis by endoscopic papillotomy [J]. N Engl J Med, 1993; 328(4): 228232.
26.	CarrLocke DL. Biliary pancreatitis [J]. Can J Gastroenterol, 2003; 17(3): 205208.
27.	Ayub K, Imada R, Slavin J. Endoscopic retrograde cholangiopancreatography in gallstoneassociated acute pancreatitis [J]. Cochrane Database Syst Rev, 2004; (4): CD003630.
28.	Schietroma M, Lattanzio R, Risetti A, et al. Treatment of acute biliary pancreatitis in the aged in the endolaparoscopic era [J]. Minerva Chir, 1999; 54(10): 677684.
29.	Forssmann K, Singer MV.How to proceed? ERCP in acute pancreatitis? [J]. Praxis (Bern 1994), 1999; 88(12): 1317.
30.	Jover R, Llach J, Bordas JM, et al. The usefulness of the timeliness of endoscopic sphincterotomy in severe acute pancreatitis of biliary origin [J]. Gastroenterol Hepatol, 1997; 20(7): 344346.
31.	Farinon AM. Acute biliary pancreatitis [J]. Ann Ital Chir, 1998; 69(6): 751763.
32.	林争, 谭国钳, 雷朝晖. 早期内镜胆总管Oddi括约肌切开术治疗急性胆源性胰腺炎 [J]. 中国内镜杂志, 2003; 9(8): 3537.

1. Schietroma M, Lattanzio R, Risetti A, et al. Diagnosis of severity as a basic parameter in the treatment of acute biliary pancreatitis [J]. Minerva Chir, 2000; 55(6): 421429.
2. Uomo G, Slavin J. Endoscopic sphincterotomy for acute pancreatitis: arguments in favour [J]. Ital J Gastroenterol Hepatol, 1998; 30(5): 557561.
3. 中华医学会消化病学分会胰腺疾病学组. 中国急性胰腺炎诊治指南(草案) [J]. 中华内科杂志, 2004; 43(3): 236238.
4. Cohen S, Bacon BR, Berlin JA, et al. National Institutes of Health StateoftheScience Conference Statement: ERCP for diagnosis and therapy, January 1416, 2002 [J]. Gastrointest Endosc, 2002; 56(6): 803809.
5. Working Party of the British Society of Gastroenterology; Association of Surgeons of Great Britain and Ireland; Pancreatic Society of Great Britain and Ireland; Association of Upper GI Surgeons of Great Britain and Ireland. UK guidelines for the management of acute pancreatitis [J]. Gut, 2005; 54(Suppl Ⅲ): Ⅲ1Ⅲ19.
6. 中华医学会消化病学分会胰腺疾病学组. 中国急性胰腺炎诊治指南(草案) [J]. 中华消化杂志, 2004; 24(3): 190192.
7. 张志功, 朱化刚, 孟翔凌, 等. APACHEⅡ、RANSON 评分在重症急性胰腺炎中的应用价值 [J]. 肝胆外科杂志, 2005; 13(1): 3235.
8. 孙明. 内科治疗学 [M]. 第12版. 北京: 人民卫生出版社, 2006: 352354.
9. 郑芝田. 胃肠病学 [M]. 北京：人民卫生出版社, 2000: 13781379.
10. Forsmark CE. The clinical problem of biliary acute necrotizing pancreatitis: epidemiology, pathophysiology, and diagnosis of biliary necrotizing pancreatitis [J]. J Gastrointest Surg, 2001; 5(3): 235239.
11. van Brummelen SE, Venneman NG, van Erpecum KJ, et al. Acute idiopathic pancreatitis: does it really exist or is it a myth? [J]. Scand J Gastroenterol Suppl, 2003; (239): 117122.
12. Kaiser AM, Saluja AK, Steer ML. Repetitive shortterm obstructions of the common bilepancreatic duct induce severe acute pancreatitis in the opossum [J]. Dig Dis Sci, 1999; 44(8): 16531661.
13. 张肇达, 田伯乐. 急性胆源性胰腺炎 [J]. 中华肝胆外科杂志, 2002; 8(2): 93.
14. 李学谦, 江堤, 顾红祥, 等. ERCP相关技术治疗胰胆道疾病219例临床分析 [J]. 赣南医学院学报, 2008; 28(4): 520521.
15. Pezzilli R, Billi P, MorselliLabate AM, et al. Anesthesiological risk and endoscopic sphincterotomy in acute biliary pancreatitis [J]. Pancreas, 2003; 26(4): 334338.
16. 袁耀宗. 胰腺病学新进展与新技术 [M]. 上海：上海科学技术文献出版社， 2001: 324325.
17. Schietroma M, Carlei F, Lezoche E, et al. Acute biliary pancreatitis: staging and management [J]. Hepatogastroenterology, 2001; 48(40): 988993.
18. 李兆申. 胆胰疾病的内镜治疗 [J]. 中国实用外科杂志, 2005; 25(6): 326328.
19. 万伟, 吴小鹏, 唐艳. LC术联合EST术治疗胆囊及胆总管结石12例 [J]. 中国现代普通外科进展, 2005; 8(3): 156.
20. Arnold JC, Benz C, Martin WR, et al. Endoscopic papillary balloon dilation vs. sphincterotomy for removal of common bile duct stones: a prospective randomized pilot study [J]. Endoscopy, 2001; 33(7): 563567.
21. 李兆申. 积极开展急性胆源性胰腺炎的内镜治疗 [J]. 胰腺病学, 2002; 2(2): 6567.
22. 张奇, 孙备. 梗阻型胆源性胰腺炎内镜治疗时机的选择 [J]. 中国普通外科杂志, 2008; 17(3): 203206.
23. 张圣道, 雷若庆. 国际胰腺病学会《急性胰腺炎外科处理指南》介绍及相关讨论 [J]. 肝胆胰外科杂志, 2003; 15(2): 133134.
24. 于澜, 姚欣敏, 胡先典, 等. 经内镜治疗急性胆源性胰腺炎30例报道 [J]. 中国普外基础与临床杂志， 2007; 14(4): 396398.
25. Fan ST, Lai EC, Mok FP, et al. Early treatment of acute biliary pancreatitis by endoscopic papillotomy [J]. N Engl J Med, 1993; 328(4): 228232.
26. CarrLocke DL. Biliary pancreatitis [J]. Can J Gastroenterol, 2003; 17(3): 205208.
27. Ayub K, Imada R, Slavin J. Endoscopic retrograde cholangiopancreatography in gallstoneassociated acute pancreatitis [J]. Cochrane Database Syst Rev, 2004; (4): CD003630.
28. Schietroma M, Lattanzio R, Risetti A, et al. Treatment of acute biliary pancreatitis in the aged in the endolaparoscopic era [J]. Minerva Chir, 1999; 54(10): 677684.
29. Forssmann K, Singer MV.How to proceed? ERCP in acute pancreatitis? [J]. Praxis (Bern 1994), 1999; 88(12): 1317.
30. Jover R, Llach J, Bordas JM, et al. The usefulness of the timeliness of endoscopic sphincterotomy in severe acute pancreatitis of biliary origin [J]. Gastroenterol Hepatol, 1997; 20(7): 344346.
31. Farinon AM. Acute biliary pancreatitis [J]. Ann Ital Chir, 1998; 69(6): 751763.
32. 林争, 谭国钳, 雷朝晖. 早期内镜胆总管Oddi括约肌切开术治疗急性胆源性胰腺炎 [J]. 中国内镜杂志, 2003; 9(8): 3537.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Research on Endoscopic Therapy for Acute Biliary Pancreatitis

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