外科与内镜治疗慢性胰腺炎合并胰管结石的疗效对比  

A Comparative Analysis of Effect Between Surgical and Endoscopic Therapy for Chronic Pancreatitis Combined with Pancreatic Ductal Stones

作　　者：弓毅[1] 王槐志[1] 

机构地区：[1]第三军医大学第一附属西南医院肝胆外科.全军肝胆外科研究所,重庆400038

出　　处：《中国普外基础与临床杂志》2016年第6期654-657,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的比较外科开腹手术与内镜治疗慢性胰腺炎(CP)合并胰管结石(PDS)的疗效差异。方法回顾性分析第三军医大学第一附属西南医院全军肝胆外科研究所2010年1月至2015年12月期间收治的113例CP合并PDS患者的临床资料,其中行手术治疗84例(手术组),行内镜治疗29例(内镜组),比较手术组和内镜组患者的临床疗效。结果手术组患者的手术时间、术中出血量、术后住院时间、总住院时间、总并发症发生率及各并发症发生率(包括胰瘘、胃排空延迟、糖尿病及急性胰腺炎)均长于(高于)内镜组(P<0.05),但二次手术率及结石复发率均较低(P<0.05),而2组患者的术后出血发生率、结石残留率及症状缓解率比较差异均无统计学意义(P>0.05)。结论对CP合并PDS患者,在结石残留和症状缓解方面,手术治疗和内镜治疗的效果相当;在手术时间、术中出血、术后住院时间及总住院时间方面,内镜组较优,但内镜治疗的二次手术和结石复发率却高于手术治疗。Objective To compare the therapy effect between surgical therapy and endoscopic therapy for chronic pancreatitis（CP） combined with pancreatic ductal stones（PDS）. Methods Clinical data of 113 cases of CP combined with PDS who got treatment in Southwest Hospital of The Third Military Medical University between January 2010 and December 2015 were analyzed retrospectively, 84 of them underwent surgery（surgery group）, and 29 of them got endoscopic therapy（endoscopy group）. Results The operative time, intraoperative bleeding volume, postoperative hospital stay, and days in hospital, mortality, incidence of complication（pancreatic fistula, delayed gastric emptying, diabetes mellitus, and acute pancreatitis） of the surgery group were all higher than those of endoscopy group（P〈0.05）, but the ratios of the two-stage surgery and recurrence of PDS were all lower（P〈0.05）. The differences between symptom remission rate and residual stones rate were not statistically significant（P〈0.05）. Conclusions For cases of CP combined with PDS, the clinical therapy effect in symptom remission and residual stones between surgical and endoscopic therapy is similar, but compared with the endoscopic therapy, the operative time, intraoperative bleeding volume, postoperative hospital stay, and days in hospital of the surgical therapy are both longer. However, the ratios of the two-stage surgery and recurrence of PDS in the endoscopy group is significantly higher than those of surgery group.

关 键 词：慢性胰腺炎 胰管结石 外科治疗 内镜治疗 疗效 

分 类 号：R657.5[医药卫生—外科学]