46例胰腺假性囊肿应用腹腔镜外科手术的诊治观察

Observation of the curative effect of laparoscopic operation in the treatment of pancreatic pseudocyst(46 cases)

目的观察腹腔镜手术治疗胰腺假性囊肿的疗效,并与传统开腹手术进行对比。方法收集该院2012年1月至2013年3月期间46例胰腺假性囊肿患者临床资料,随机分为观察组和对照组,每组各23例。观察组采用腹腔镜进行治疗,对照组采用开放手术进行治疗,对疗效进行分析。结果观察组患者治疗的成功率及复发率分别为82.6%和13.0%,对照组为69.7%及17.4%,两组患者的成功率及复发率差异无显著性(χ2=1.08,0.00,P>0.05)。观察组患者术中出血量(72.9±15.9)mL、手术时间(120.3±33.5)min以及住院时间(8.9±2.2)d均明显低于对照组[分别为(151.8±34.1)mL,(154.8±42.7)min及(14.7±4.1)d],差异具有显著性(t=10.06,3.05,5.98,P<0.01)。两组患者并发症的发生率差异无显著性(P>0.05)。结论在严格控制手术适应证,由专业熟练的医师在合适的手术时机,通过施行腹腔镜下的囊肿空肠Roux-en-y吻合术可以获得比较满意的治疗效果,并且具有手术时间短,住院时间少等优点,这些对于加快患者康复,降低患者及家属的经济负担均有重要的意义,值得广泛推广。

[ Objective ] To observe the clinical curative effect of laparoscopic operation in the treatment of 46 pancreatic pseudocyst and compared with the open surgery. [ Methods ] 46 cases pancreatic pseudocyst were se- lected and divided into two groups （observation group and control group）. Each group was 23 cases. The patients in observation group were given laparoscopic operation and the patients in control group were got open surgery. IRe- suits ] The cure rate and recurrence rate of the treatment group was 82.6% and 13.0%,the control group was 69.7% and 17.4%, there was no significant difference between the two groups （χ=1.08, 0.00, P 〉0.05）. But the bleeding volume （72.9±15.9） mL, operation time （120.3±33.5） min and length of hospital stay （120.3±33.5） min of observation group was all much shorter than the control group （151.8±34.1）mL, （154.8±42.7）min, （14.7±4.1） respectively）（t= 10.06, 3.05, 5.98, P 〈0.01）. [ Conclusion ] In the strict control of surgical indications at suitable operation time, ap- ply Laparoscopic Operation for the Treatment of Pancreatic Pseudocyst by professional skilled physicians can obtain satisfactory curative effect, with shorter operation time, less time in hospital, less time to recovery, reduce the eco- nomic burden of patients and their families. Therefore it is worth popularizing widely.