腹腔镜胆囊切除术治疗急性胰腺炎合并胆囊结石的应用体会

The application of laparoscopic cholecystectomy in the treatment of acute pancreatitis with gallbladder stones

目的：探讨腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）在治疗急性胰腺炎合并胆囊结石中的微创意义和临床可行性。方法：采用剖腹探查或先保守治疗再行LC治疗急性胰腺炎合并胆囊结石66例，其中32例行急诊剖腹胆囊切除胆总管探查和胰包膜切开引流术；先行保守治疗34例，待酶学正常两周后再择期行LC。结果：66例均治愈，剖腹探查组2例切口感染，5例粘连性肠梗阻，探查胆总管结石阴性率96．9％；保守治疗后再行LC治疗组1例切口感染，无粘连性肠梗阻。随访1～3年，无胰腺炎复发。结论：LC可应用于轻症急性胰腺炎合并胆囊结石的治疗，并具有微创意义。

Objective： To explore the minimal invasive effection and clinical feasibility of laparoscopic cholecystectomy （LC） in the treatment of acute pancreatitis with gallbladder stones. Methods： The clinical data of 66 cases received open abdominal exploration or LC to treat acute pancreatitis with gallbadder stones was analyzed retrospectively, among whom 32 cases had traditional means and the other 34 cases were conservatively treated at first and underwent LC two weeks later after the enzymes of pancreatitis had been normal. Results ： All the 66 cases were cured. 2 cases had incisional infection and 5 cases suffered from adhesive intestinal obstruction in open abdominal exploration group,and the negative result rate in common bile duct exploration was 96.9%. While in the laparoscopic cholecystectomy group, 1 case had incision infection, and no adhesive intestinal obstruction was found. No recurrence of pancreatitis was found during the follow-up period of 1-3 years. Conclusions：LC is minimal invasive and feasible in the treatment of acute pancreatitis with gallbaldder stones.