急性胆源性胰腺炎腹腔镜胆囊切除术手术时机探讨  

The Timing of Laparoscopic Cholecystectomy for Acute Biliary Pancreatitis

作　　者：顾勇劲[1] GU Yongjin(Department of General Surgery,Second People's Hospital of Changshu City,Changshu,Jiangsu Province,215500 China)

机构地区：[1]江苏省常熟市第二人民医院普外科,江苏常熟215500

出　　处：《中外医疗》2021年第28期60-62,共3页China & Foreign Medical Treatment

摘　　要：目的探究急性胆源性胰腺炎(ABP)行腹腔镜胆囊切除术(LC)不同时机的选择。方法方便选取2015年2月—2020年2月范围内该院收治的100例ABP患者进行回顾性分析,按照手术时机不同分为早期组(n=60)和择期组(n=40),早期组对症支持后,发病2周以内进行LC手术,择期组进行保守治疗后,发病>2周后进行LC手术。观察两组手术各项指征、疾病转归、并发症发生率以及血液生化指标恢复时间。结果早期组手术时间(1.04±0.03)h、住院时间(19.32±4.24)d和术后排气时间(51.23±6.23)h均短于择期组,差异有统计学意义(t=23.506、17.985、11.869,P<0.05);早期组复发率、治愈率优于择期组,差异有统计学意义(P<0.05);早期组乳酸、D-二聚体和白细胞恢复时间明显短于择期组,差异有统计学意义(P<0.05)。结论ABP患者行LC,在患者病情允许下选择早期手术效果较好,能有效缩短住院时间,减轻患者经济负担。Objective To explore the different timing of laparoscopic cholecystectomy(LC)for acute biliary pancreatitis(ABP).Methods 100 cases of ABP patients admitted to the hospital from February 2015 to February 2020 were selected conveniently for retrospective analysis.According to the timing of surgery,they were divided into early group(n=60)and elective group(n=40).After symptomatic support in the group,LC surgery was performed within 2 weeks after the onset of disease,and the elective group received conservative treatment,and LC surgery was performed after the onset of disease was greater than 2 weeks.Observe the indications,disease outcome,complication rate and recovery time of blood biochemical indicators in the two groups.Results The operation time(1.04±0.03)h,hospitalization time(19.32±4.24)d and postoperative exhaust time(51.23±6.23)h in the early group were shorter than those in the elective group,and the difference was statistically significant(t=23.506,17.985,11.869,P<0.05);the recurrence rate and cure rate of the early group were better than those of the elective group,the difference was statistically significant(P<0.05);the recovery time of lactic acid,D-dimer and white blood cells in the early group was significantly shorter than that of the elective group,and the difference was statistically significant(P<0.05).Conclusion Patients with acute biliary pancreatitis underwent laparoscopic cholecystectomy.It is better to choose early operation if the patient's condition permits,which can effectively shorten the hospital stay and reduce the economic burden of the patient.

关 键 词：胆囊切除 腹腔镜手术 ABP 手术时机 

分 类 号：R657.4[医药卫生—外科学]