不同时机行腹腔镜下胆囊切除术对急性胆源性胰腺炎患者临床疗效与安全性的影响  

Impact of Different Timing of Laparoscopic Cholecystectomy on Clinical Efficacy and Safety of Patients with Acute Biliary Pancreatitis

作　　者：时培岑 朱宗文 杨岩 李国庆 SHI Peicen;ZHU Zongwen;YANG Yan;LI Guoqing(Department of Hepatobiliary SurgeryⅡ,Shanxian Central Hospital,Heze,Shandong,274300,China)

机构地区：[1]单县中心医院肝胆外二科,山东菏泽274300

出　　处：《中外医疗》2025年第1期39-43,共5页China & Foreign Medical Treatment

摘　　要：目的评估急性胆源性胰腺炎患者在不同时机接受腹腔镜下胆囊切除术的疗效与手术安全性差异。方法回顾性选取2022年1月-2024年1月单县中心医院收治的98例急性胆源性胰腺炎患者的临床资料,根据不同治疗方法分为早期手术组、延期手术组,每组49例。早期手术组在常规急性胰腺炎治疗1周左右进行手术,延期手术组在常规急性胰腺炎治疗1个月后手术。对比两组手术相关指标、应激水平、免疫功能及并发症发生情况。结果两组术中失血量、手术操作时间、首次排气时间、首次进食时间、首次排便时间对比,差异均无统计学意义(P均>0.05);早期手术组住院时间(12.42±2.33)d,短于延期手术组的(23.36±4.17)d,差异有统计学意义(t=16.032,P<0.05)。术前、术后,两组应激水平对比,差异均无统计学意义(P均>0.05)。术前、术后,两组免疫功能对比,差异均无统计学意义(P均>0.05)。早期手术组并发症总发生率低于延期手术组,差异有统计学意义(P<0.05)。结论急性胆源性胰腺炎早期行腹腔镜下胆囊切除术,可有效缩短住院周期,不增加患者应激反应或影响免疫功能,且并发症风险较低。Objective To evaluate the efficacy and safety of laparoscopic cholecystectomy in patients with acute bili-ary pancreatitis at different times.Methods The clinical data of 98 patients with acute biliary pancreatitis admitted to Shanxian Central Hospital from January 2022 to January 2024 were retrospectively selected.According to different treatment methods,they were divided into early operation group and delayed operation group,with 49 cases in each group.The early operation group was treated with routine acute pancreatitis for about 1 week,and the delayed opera-tion group was treated with routine acute pancreatitis for 1 month.The operation related indexes,stress level,immune function and complications were compared between the two groups.Results There were no significant difference in in-traoperative blood loss,operation time,first exhaust time,first feeding time and first defecation time between the two groups(all P>0.05),the hospitalization time of the early operation group was(12.42±2.33)d,which was shorter than that of the delayed operation group(23.36±4.17)d,and the difference was statistically significant(t=16.032,P<0.05).Before and after operation,there were no significant difference in stress level between the two groups(both P>0.05).Before and after operation,there were no significant difference in immune function between the two groups(both P>0.05).The total incidence of complications in the early operation group was lower than that in the delayed operation group,and the difference was statistically significant(P<0.05).Conclusion Early laparoscopic cholecystectomy for acute biliary pancreatitis can effectively shorten the hospitalization period,without increasing the stress response or af-fecting the immune function of patients,and the risk of complications is low.

关 键 词：急性胆源性胰腺炎 腹腔镜胆囊切除术 疗效 安全性 

分 类 号：R6[医药卫生—外科学]