不同手术时机在LC联合EST治疗轻型急性胆源性胰腺炎中的疗效  

Effect of operation timing on efficacy of laparoscopic cholecystectomy combined with endoscopic sphincterotomy for patients with mild acute biliary pancreatitis

作　　者：尹碧辉[1] 

机构地区：[1]仙桃市第一人民医院普外科,湖北省仙桃市433000

出　　处：《世界华人消化杂志》2015年第12期1980-1983,共4页World Chinese Journal of Digestology

摘　　要：目的:比较轻型急性胆源性胰腺炎(mild acute gallstone pancreatitis,MAGP)患者不同手术时机行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合十二指肠镜下乳头切开术(endoscopic sphincterotomy,EST)治疗的临床效果.方法:按照不同手术时间将86例MAGP患者分为实验组(早期手术)45例和对照组(延期手术)41例,比较两组患者插管情况、术后结石残留情况、并发症发生情况、术后住院时间及治疗总费用.结果:两组患者插管成功率比较(91.11%vs95.12%),差异无统计学意义(P>0.05);实验组患者术后结石残留率显著低于对照组(6.67%v s 26.83%),差异具有统计学意义(P<0.05);两组患者术后各并发腹腔积液、呼吸窘迫综合征、应激性溃疡、出血、胰腺炎加重发生率比较(0.00%vs 2.44%、4.44%vs 2.44%、6.67%vs 2.44%、2.22%vs0.00%、6.67%vs 2.44%),差异无统计学意义(P>0.05).实验组患者术后住院时间及治疗总费用均显著低于对照组(6.27 d±1.56 d vs 13.85 d±1.75 d)、(6720.55元±452.38元v s 9527.82元±711.06元),差异具有统计学意义(P<0.05).结论:早期手术能够有效提高MAGP结石清除率,减少术后住院时间及住院费用,不会增加术后并发症发生率,较延期手术更具临床优势.AIM： To assess the effect of operation timing on efficacy of laparoscopic cholecystectomy （LC） combined with endoscopic sphincterotomy （EST） for patients with mild acute biliary pancreatitis （MABP）.were divided into an experiment group （45 cases, early operation） and a control group （41 cases, delayed surgery） according to the operation timing. The intubation success rate, postoperative residual calculi, complications, hospitalization time after operation, and total treatment costs were compared for the two groups. RESULTS： There was no significant difference in the rate of successful intubation （91.11% vs 95.12%, P 〉 0.05）. The rate of postoperative residual calculi for the experiment group was significantly lower than that for the control group （6.67% vs 26.83%, P 〈 0.05）. There was no significant difference in the rates of complications （0.00% vs 2.44%, 4.44% vs 2.44%, 6.67% vs 2.44%, 2.22% vs 0.00%, 6.67% vs 2.44%, P 〈 0.05）. The hospitalization time after operation and total treatment costs for the experiment group were significantly lower than those for the control group （6.27 d ± 1.56 d vs 13.85 d ± 1.75 d, 6720.55 yuan ± 452.38 yuan vs 9527.82 yuan ± 711.06 yuan, P 〈 0.05）. CONCLUSION： MABP can improve the rate of postoperative residual calculi and reduce hospital stay and total treatment costs, but does not increase the rates of complications.

关 键 词：轻型急性胆源性胰腺炎 手术时机 腹腔镜胆囊切除术 十二指肠镜下乳头切开术 

分 类 号：R657.51[医药卫生—外科学]