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Objective To investigate a rational treatment for severe gallstone pancreatitis(SGP) and evaluate therapeutic effect.Methods A retrospective study was made on the clinical data of 97 cases with SGP.(Results) Among 97 SGP patients,54 cases were in severe grade I, 43 cases were Grade II;77(79.4%) cases were cured and 20(20.6%)died.The morbidity rates of endoscopic therapy(EST),delayed surgery and early surgery were 24.1%,25.0% and 65.5% respecticely,while the mortality rates in the 3 groups were 10.3%,13.9% and 37.5% respectively.The morbidity and morality rates in the first 2 groups were significanty lower than the early surgery group(P
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Objective To explore the role of apoptosis in the pathogenesis of acute pancreatitis(AP)and to (investigate) the effect of ligustrazin(LGT) on the apoptosis in acute pancreatitis .Methods Experimental animals were divided into three groups randomly: (1) AP group, (2) comparison group,and (3) therapy group. Pathologic score and TUNEL method were used to detect the pathologic mophology of pancreatic tissue and the pancreatic cell apoptosis index in the 3 groups. Results In the early stage of AP,the majority of cells are apototic and the degree of AP is slight.In the late stage of AP,the majority of cells show necrosis,and the degree of AP is severe.The (induction) of cell apoptosis can lessen the pathologic state of AP. Conclusions The degree of pathologic changes in AP can be lessened by the induction of cell apoptosis,but there is a definte time limit.
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Objective To elucidate the clinical features,and the principles in diagnosis and treatment of hyperlipidemic pancreatitis.Methods The clinical data of 262 cases with acute pancreatitis from January,2004 to April,2006,were studied.Results Among 262 cases,46 cases were diagnosed as hyperlipidemic pancreatitis(17.5%,46/262),that included 32 cases with mild acute pancreatitis(69.0%) and 14 cases with severe acute pancreatitis(31.0%).Depending on the severity of pancreatitis,different treatments were adopted.Among the 46 cases,10 were treated operatively.As a result,43 cases were cured,accounting for 93.5% of all cases,and 3 cases died,accounting for 21.4% of cases with severe acute pancreatitis.Conclusions Hyperlipidemia can induce acute pancreatitis,and many may have severe pancreatitis.Treatment is mainly by nonoperative management but different therapeutic measures should be adopted according to the severity of pancreatitis.
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Objective To explore the role of inflammatory mediators in the pathogenesis of acute pancreatitis(AP).Methods Observation the relationship betweent the changes in serum TNF and IL-6 and(histopathology) of the pancreas in AP rats.Results(1)Rats in sham operation group survived throughout the experiment.Compared with of sham operation group,in AP group survival time shortened significantly(P
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Objective To observe the effect of laparoscopic surgery for patients with acute gallstone pancreatitis(AGP). Methods The clinical data of 134 patients suffered from AGP treated with laparoscopy surgery since 2000 in our hospital were analyzed retrospectively.Results All the patients were treated with laparoscopic surgery successfully. Among them, 21 cases were treated with laparoscopic cholecystectomy (LC);113 cases with LC and exploration of common bile duct,induding 75 cases received opening the pancreatic capsule and placement of irregation tubes for postoperative washing the abdominal cavity during the same operation. One hundred and tweent-six cases(94.0%) cured, 6 cases(4.5%) died, 2 cases( 1.5%) discharged themself. Conclusions Laparoscopic surgery in the treatment of early stage of AGP can get good results and improve the prognosis remarkably.It is worth to be used widely.
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Objective To evaluate the clinical classification and timing of surgery in the treatment of gallstone acute pancreatitis(GAP). Method The clinical data of 109 patients with GAP admitted to the Department of General Surgery of our hospital were retrospectively analysed. Result and Conclusion Based on the analysis of the treatment methods and its outcome, GAP should be divided into four types according to ampullary obstruction and severity of acute pancreatitis. (1)Non-obstructive mild type GAP was treated mainly in conservative way.(2)Obstructive mild type GAP could be treated conservatively for 36 hours after onset. If the obstruction did not resolve, surgery should be done. (3)Obstructive severe type GAP was treated mainly in conservative way, and the timing of surgery depends on whether necrosis complicated with infection. (4)Obstructive severe type GAP: EST should be done first. If EST is not convenient to be done, an early surgery should be done after short period of supportive therapy. Special attention should be paid to, if suppurative cholecystitis or cholangitis presented, an emergency surgery should be done. Finally, for all the GAP treated by conservative treatment, an elective surgery should be performed to resolve the biliary disease.
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Objective To investigate the endoscopic diagnosis and therapy for patient with relapsing pancreatitis after cholecystectomy. Methods The clinical data of 21 patients with relapsing pancreatitis after cholecystectomy underwent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) were analyzed. Results Nineteen out of 21 patients were diagnosed as sphincter of Oddi dysfunction (SOD), and remaining 2 patients as choledocholith iasis. The treatment outcome of EST for the 21 patients in short-term after EST was satisfactory, and there was no complication of EST. Conclusions ERCP has a great value in the diagnosis of the cause of relapsing pancreatitis after cholecystectomy.The treatment of EST for patients with relapsing pancreatitis after cholecystectomy is safe and effective.