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Clinical Study Of Acute Biliary Pancreatitis

Posted on:2016-08-14Degree:DoctorType:Dissertation
Country:ChinaCandidate:B LuFull Text:PDF
GTID:1314330482957995Subject:Digestive medicine
Abstract/Summary:PDF Full Text Request
Objective:To study the characteristics of biliary pancreatitis in the etiology,pathogenesis,clinical manifestations and clinical treatment. To understand the gallbladder and the mechanism of gallbladder stones in the development of biliary pancreatitis.To investigate the relationship among gallbladder stone size, the number of stones, the size of gallbladder, bile duct stones and acute biliary pancreatitis. To provide clinical evidence for the prevention and treatment of biliary pancreatic pancreatic.Methods:We choose 118 patients in our hospital from January 2007 to December 2010 due to abdominal pain and they are be diagnosed as gallbladder stones.We measure the size of gallbladder, the size of the gallbladder stone, the number of gall bladder stones and the stones of the common bile duct according to B-mode ultrasonography. Some of them are measured by MRCP. We groupe these patients by concurrent pancreatitis.Among them there are 61 cases with biliary pancreatitis. The diagnostic criteria for pancreatitis is in accordance with the diagnostic criteria for acute pancreatitis guidelines in China,2013. The diagnosis is based on biochemical and CT findings of the patients during hospitalization.We have counted the rates of the incidence of pancreatitis in each group, to see whether there is statistical significance, to determine the correlation between gallstone and biliary pancreatitis.Result:The results of our study is that, there are 49 cases have pancreatitis in the group of normal gallbladder size among 74cases, the occurrence rate is 66.2%; Among 44 cases of gallbladder enlargement or gallbladder narrowing group, there are 12 cases of acute pancreatitis, the occurrence rate is 27.3%, the difference between them is significant (?2=16.758 P=0.000). There are 11 cases have pancreatitis in the group of solitary gallbladder stone among 31 cases, the occurrence rate is 35.5%; Among 87 cases of multiple gallbladder stone group, there are 50 cases with acute pancreatitis, the occurrence rate is 57.5%, the difference between them has significant (x2=4.425 P=0.029). There are 61 cases of acute pancreatitis.Among them 11 cases with solitary stone, the stone bigger than 10 mm is 8,3 cases of stones smaller than 10mm.In multiple gallbladder stone group, the stone bigger than 10 mm is 9,41 cases of stones smaller than 10mm. The difference between them is significant (x2=13.434 P=0.001). Among the 118 patients, there are 19 patients with common bile duct stones,17 cases of which have pancreatitis, and 99 cases without common bile duct stones,44 cases of which had pancreatitis, the difference between them is significant (x2=12.994 P=0.000)Conclusion:Gallstone pancreatitis has its own characteristics.The pathogenesis, diagnosis and treatment of biliary pancreatitis are different from other causes of pancreas. The stones which are smaller than 1cm normal-sized gallbladder, multiple gallbladder stone and common bile duct stones can cause pancreatitis easily. By understanding the patient's gallbladder, cholecystolithiasis and bile ducts corresponding calculus case, we can prevent the occurrence of pancreatitis, understand the patient's prognosisand and provide the basis for treatment. It can help provide the basis for the follow-up endoscopy and surgical treatment.It's also useful to understand the incidence and prognosis for biliary pancreatitis.As a department of gastroenterology doctor this has important clinical significance for us to guide the prevention and treat patients with gallstones.
Keywords/Search Tags:gallstones, gallbladder number of stones, stone size, cholecystolithiasis, acute pancreatitis
PDF Full Text Request
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