Acute pancreatitis and pregnancy: A 10-year single center experience
Acute pancreatitis and pregnancy: A 10-year single center experience
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DOI：
10.1007/s11605-007-0329-2
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发表时间：
2007-12-01
影响因子：
3.2
通讯作者：
Tavakkolizadeh, Ali
中科院分区：
文献类型：
--
作者：
Hernandez, Alejandro;Petrov, Maxim S.;Tavakkolizadeh, Ali
背景 妊娠期急性胰腺炎很少见。我们报告了我们对该疾病的机构治疗方法及其对孕产妇和胎儿结局的影响。方法对 1996 年至 2006 年间入住布莱根妇女医院的孕妇的医疗记录进行回顾性审查。结果确定了 21 名患者，共出现 34 次急性胰腺炎发作。大多数发作（56%）发生在妊娠中期。十二名患者患有胆源性胰腺炎。其中三人患有继发于其他原因的胰腺炎，六人的病因“未确定”。在胆源性胰腺炎患者中，六人接受了胆囊切除术；其中三分之一的病例最初的保守治疗失败了。其他 6 名患者接受内镜下乳头括约肌切开术 (n=2) 或保守治疗 (n=4)。保守治疗的胆源性胰腺炎患者中有 50% 出现胰腺炎复发，而胆囊切除组则没有复发。三个治疗组（胆囊切除术、括约肌切开术和保守治疗）之间的住院时间没有显着差异。没有观察到孕产妇死亡； 4例早产，1例流产。结论妊娠期胆源性胰腺炎患者若保守治疗，复发率较高。早期手术干预是适当、安全的，并且不会增加住院时间。
Background Acute pancreatitis in pregnancy is rare. We report our institutional therapeutic approaches to this disease and its effect on maternal and fetal outcomes.Methods A retrospective review of medical records of pregnant women admitted to Brigham and Women's Hospital between 1996 and 2006.Results Twenty-one patients, presenting with 34 episodes of acute pancreatitis were identified. Most attacks (56%) occurred in the second trimester. Twelve patients had biliary pancreatitis. Three had pancreatitis secondary to other causes and six had "undetermined" etiologies. Of those with biliary pancreatitis, six underwent cholecystectomy; in a third of these cases, initial conservative therapy had failed. The other six patients underwent endoscopic sphincterotomy (n=2) or conservative therapy (n=4). Fifty percent of the patients with biliary pancreatitis managed conservatively had a recurrent episode of pancreatitis vs none in the cholecystectomy group. There was no significant difference in length of hospital stay between the three treatment groups (cholecystectomy, sphincterotomy, and conservative therapy). No maternal deaths were observed; there were four preterm labors and one fetal loss.Conclusion If treated conservatively, pregnant patients with biliary pancreatitis appear to have a high recurrence rate. Early surgical intervention is appropriate, safe, and does not increase the length of hospital stay.