推 alcoholic:NEJM2006是建議ERCP+endoscopic sphincterotomy 02/20 02:53
推 terry95:要看當時被照會的GI man的心情還有醫院科別的制度.. 02/20 15:42
→ terry95:Aggresive的GI man 早就抓去做ERCP了.. 02/20 15:42
※ 引述《doctoja ( )》之銘言：
: 什麼情況下需要作？
: 謝謝
CT scan is the most important imaging test for the diagnosis of acute
pancreatitis and its intraabdominal complications and also for assessment of
severity. Patients with clinical and biochemical features of acute
pancreatitis who do not improve with initial conservative therapy or who are
suspected of having complications should undergo CT scan of the abdomen.
-- UpToDate
查到這兒，突然想到一個先前就不太懂的問題：
acute biliary pancreatitis，到底治療原則為何？
先前曾遇過病人有CT-proved CBD stone + acute pancreatitis，
第一時間照會了GI man，回覆為"acute pancreatitis不做ERCP"。
剛看了UptoDate，似乎是建議做endoscopic sphincterotomy，
這是代表只去切開papilla，而不做ERCP的意思嗎？
或者，是太早照會了，要等到有progressive jaundice的證據出現，
才會被抓去做ERCP呢？
--
帥哥出沒....
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