Résumé
Objective To discuss clinical effects of combined use of duodenoscopy and laparoscopy in the treatment of acute billiary pancreatitis (ABP), and to establish a systematic protocol of minimally invasive treatment for ABP. Methods According to the patients’ biliary tract conditions, severity of disease and treatment methods, a total of 696 patients with ABP were given laparoscopic cholecystectomy (LC) alone, or endoscopic retrograde cholangiopancreatography (ERCP) and LC, or ERCP and laparoscopic common bile duct exploration (LCBDE), or ERCP and endoscopic sphincterotomy (EST), or individualized treatment for severe acute pancreatitis (SAP). Clinical effects were observed. Results Among the 696 patients, 330 patients (47.4%) received EST and biliary stones were successfully removed under endoscope in 267 patients (38.4%). ERCP, LC and LCBDE were conducted in 411 (59.1%), 513 (73.7%) and 85 (12.2%) patients, respectively, and successfully accomplished in 409 (99.5%), 511 (99.6%) and 82 (96.5%) patients, respectively. Out of 36 patients with SAP, 34 patients survived (94.4%). The total cure rate was 99.7% (694/696). Conclusions Combined use of duodenoscopy and laparoscopy is significantly effective for acute billiary pancreatitis and benefits the improvement and standardization of the protocol of minimally invasive treatment for acute billiary pancreatitis.