腹腔镜下手术治疗重症急性胰腺炎的手术时机和疗效探讨

目的 探讨腹腔镜下手术治疗重症急性胰腺炎的手术时机和手术治疗效果。方法 对住院通过腹腔镜下手术治疗的30例重症胰腺炎患者的手术时机和手术效果进行回顾性分析。结果 30例重症急性胰腺炎患者的手术时间为111～260 min,平均手术时间（165±30）min;患者的住院时间为19～30 d,平均住院时间（19.5±3）d10其中3例胰腺脓肿并急性肾功能不全患者引流术后3 d出现严重呼吸功能不全,术后7 d死于多系统器官功能衰竭。其余27例患者恢复正常,痊愈出院,总有效率为90%。结论 腹腔镜下治疗重症急性胰腺炎对机体的创伤性小、干扰少,冲洗引流可靠,可以有效减少重症急性胰腺炎术后并发症的发生,是一种安全、可靠的治疗方法,但是手术时机的选择对治疗效果有重要影响。

Objective To analyze effect of operation timing and operative treatment of laparoscopic operation in the treatment of severe acute pancreatitis. Methods After laparoscopic operation, operation timing and operative effect of 30 hospitalized patients with severe acute pancreatitis were analyzed retrospectively. Results The operation time of 30 patients with severe acute pancreatitis was 111-260 min, the average operation time was （165±30）min; hospitalization time was 19-30 d, the average time was （19.5±3）d. 3 cases of pancreatic abscess with acute renal failure happened severe respiratory insufficiency 3 days after poor drainage, and died of multiple system organ failure 7 d after operation. The remaining 27 patients were healed, and the total effective rate was 90%. Conclusion For patients with severe acute pancreatitis, laparoscopic operation with less trauma, interference, and reliable irrigation and drainage, can effectively improve the prognosis, and is a safe and reliable treatment, but the choice of operation time the is very important for therapeutic effect.