胆源性胰腺炎早期行腹腔镜胆囊切除术的可行性及手术时机  

Early Laparoscopic Cholecystectomy in Acute Biliary Pancreatitis

作　　者：竺来法[1] 赵晖[1] 

机构地区：[1]无锡市第二人民医院肝胆外科,江苏无锡214002

出　　处：《中国血液流变学杂志》2013年第4期679-681,共3页Chinese Journal of Hemorheology

摘　　要：目的：探讨胆源性胰腺炎早期行腹腔镜胆囊切除术（LC）的可行性及手术时机。方法胆源性胰腺炎患者125例经过保守治疗后，根据手术时间，分为早期手术组（ELC，入院后7 d内行LC）71例和择期手术组（ILC，出院6～8周择期行LC）54例。比较2组手术难度、手术时间、中转开腹率、术后并发症发生率、住院天数。结果胆囊水肿ELC组42例， ILC组13例（P＜0.05）。胆囊周围粘连ELC组21例，ILC组30例（P＜0.05）。胆囊三角分离困难ELC组17例，ILC组14例（P＞0.05）。中转开腹ELC组7例，ILC组4例。累计住院天数ELC组10.2＆#177;2.3 d，ILC组17.4＆#177;3.5 d（P＜0.05）。ILC组有35.2%的患者在等待手术过程中因胆源性胰腺炎复发入院。结论早期LC并没有增加胆源性胰腺炎患者的手术难度、手术时间、中转开腹率和术后并发症发生率，相反大大降低了住院时间和再入院率。Objective To explore the early laparoscopic cholecystectomy （LC） in acute biliary pancreatitis （ABP）. Methods 125 cases of ABP from 2002 to 2011 were retrospectively reviewed. Conservative treatment was administered in all cases. Cases of ABP undergoing LC within 7 days and within 6 to 8 weeks were assigned to early laparoscopic cholecystectomy （ELC, n=71） and interval laparoscopic cholecystectomy （ILC, n=54） re-spectively to compare the dififculty of LC, operating time, incidence of conversion, morbidity and hospital stay. Results There was no signiifcant difference between ILC and ELC in terms of the dififculty of LC, operating time, incidence of conversion and morbidity （P〉0.05）. Whereas the hospital stay was signiifcantly lower in ILC than ELC （P〈0.05）. 35.2%of patients in ILC were re-admitted to hospital in waiting for surgery because of recur-rence of ABP. Conclusion Early laparoscopic cholecystectomy didn’t increase the dififculty of LC, operating time, incidence of conversion and morbidity for patients with ABP, but on the contrary greatly reduce the hospital stay and readmission rate.

关 键 词：急性胆源性胰腺炎 腹腔镜胆囊切除术 

分 类 号：R657.51[医药卫生—外科学]