The Clinical Study Of Endoscopy Therapy In The Patients With Acute Billiary Pancreatitis

Objective To explore the applying value and timing of endoscopic sphincterotomy(EST) and endoscopic naso-billa drainage(ENBD) in the treatment of acute billiary pancreatitis(ABP). Methods 30 patients with acute billiary pancreatitis(ABP), including 20 MABP and 10 SABP, underwent ERCP/EST/ENBD(ERCP group). Another 30 patients were treatment conservatively and 30 surgically . And all patients were observed for the decrease of white blood cell,serum amylase,urine amylasejiver function, the disappearance of abdominal pain and signs of peritoneal irritation,the mean days of hospitalization, complication and mortality. Results In ERCP group 17 patients underwent EST/ENBD within 48 hours after admission:8 ENBD within 24 hours,9 EST/ENBD in 24-48 hours,including 2 EST+ENBD, 4 ENBD and 3 EST alone.And 6 patients underwent EST/ENBD after 48 hours of admission:2 EST/ENBD,2ENBD,2EST.Urgent ENBD was performed within 24 hours in 5 patients complicated by acute obstructive supurative cholangitis(AOSC) and 2 patients with severe acute billiary pancreatitis (SABP)because of the deteriorated clilical conditions,followed by EST/ENBD after the symptom had improved. It was significant shorter that the days of decrease of white blood cell of all patients with acute billiary pancreatitis (ABP),decrease of liver function,the disappearance of abdominal pain andThe clinical study of endoscopy therapy in the patients with acute billiary pancreatitis______________________Abstractsigns of peritoneal irritation and hospitalization of the patients with SABP bewteen the ERCP group and the routine conservative treatment group (MABP: 8.64+1.83 vs.10.75 + 2.35 P<0.05 , SABP: 10.5 + 3.26vs.l4.57 + 3.74 P<0.05, 10.67 + 3.06vs. .20 + 5.4 P<0.05, 9 + 3.11vs.l4.86 + 5.6 P< 0.01, 11.29 +3.28vs.l5.29 +3.43 P<0.01, 20.67 + 4.63vs.28 + 6.83 P< 0.01) .And the complications were least(2vs.6)and mortality lower(0vs.20%) but there were no statistical significance. Between the ERCP group and the surgical group, it was significant shorter that the days of decrease of white blood cell and liver function and the days of hospitalization of the patients with SABP (10.5 + 3.26vs.l5.33 + 2.53 P<0.05 , 10.67 + 3.06vs.l9 + 6.0 P< 0.05, 20.67 + 4.63vs.48.29 + 10.8 P<0.001) and the complications were least (2vs.7 P < 0.05),mortality lower (Ovs.20%) but there were no statistical significance .There were no statistical signifmance in the days of decrease of serum and urine amylase of all patients .Conclusion EST and ENBD are safe and effective within 24-48 hours after admission in patients with SABP and better than conservative or surgical treatment ,but not found to be better in patients with MABP.EST and ENBD don't deteriorate the clinical conditions of the patients with MABP.