不同手术时机运用腹腔镜治疗胆囊结石所致急性胰腺炎的效果及安全性分析  

Analysis of efficacy and safety of laparoscopic treatment of acute pancreatitis by cholecystolithiasis at different operative times

作　　者：徐梓恒 孙磊[1] 胡伟[1] XU Ziheng;SUN Lei;HU Wei(Department of Hepatobiliary Surgery,the First People’s Hospital of Lianyungang,Jiangsu Province,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市第一人民医院肝胆外科,江苏连云港222000

出　　处：《中国医药导报》2021年第13期76-79,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81370569)。

摘　　要：目的探讨不同手术时机运用腹腔镜治疗胆囊结石所致急性胰腺炎(AP)的效果及安全性。方法回顾性分析2018年2月—2020年2月江苏省连云港市第一人民医院收治的92例胆囊结石所致AP患者的资料。根据LC治疗时间将其分为两组,每组46例。其中入院确诊后48 h内(记为早期)进行LC治疗的46例患者为A组,入院确诊后首先接受药物治疗待病情稳定后8~12周(记为择期)进行LC治疗的46例患者为B组。比较两组相关康复指标、生化指标、安全性及复发情况。结果两组手术时间、术中出血量比较,差异无统计学意义(P>0.05),A组术后住院时间短于B组,差异有统计学意义(P<0.05);两组术后切口感染、发热、胆漏发生率及并发症总发生率比较,差异无统计学意义(P>0.05);两组术后复发率比较,差异无统计学意义(P>0.05)。结论胆囊结石所致AP患者入院确诊后48 h内行LC治疗可有效缩短术后住院时间,早期与择期进行LC治疗效果相当,均不加重患者肝功能损害,安全性良好。Objective To investigate the efficacy and safety of laparoscopic treatment of acute pancreatitis(AP)caused by cholecystolithiasis at different operative times.Methods A total of 92 AP caused by cholecystolithiasis patients admitted to the First People’s Hospital of Lianyungang from March 2018 to February 2020 were retrospectively analyzed.According to the time of LC treatment,they were divided into two groups,with 46 cases in each group.Among them,46 patients who underwent LC treatment within 48 hours after admission(recorded as early stage)were classified as group A,and 46 patients who received LC treatment after admission and confirmed that they firstly received drug treatment and waited for 8 to 12 weeks after their condition was stable(recorded as elective)as group B.The related rehabilitation indicators,biochemical indicators,safety and recurrence were compared between the two groups.Results There were no statistically significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).The postoperative hospital stay in group A was shorter than group B,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of wound infection,fever,bile leakage and total incidence of postoperative complications between the two groups(P>0.05).There was no statistically significant difference in the recurrence rate between the two groups(P>0.05).Conclusion LC treatment for AP patients caused by gallbladder stones within 48 hours after admission to the hospital can effectively shorten the length of postoperative hospital stay.The effect of early LC treatment is equivalent to that of elective LC treatment,and it does not aggravate the liver damage of the patient,and the safety is good.

关 键 词：手术时机 腹腔镜治疗 胆囊结石 急性胰腺炎 疗效 

分 类 号：R657.51[医药卫生—外科学]