内镜联合腹腔镜治疗重症急性胰腺炎并发胰腺假性囊肿的临床疗效观察

Clinical efficacy of endoscopic plus laparoscopic treatment for severe acute pancreatitis complicated with pancreatic pseudocyst

目的:探讨内镜联合腹腔镜治疗重症急性炎(SAP)并发胰腺假性囊肿(PPC)的临床疗效。方法:选取2012年6月—2014年3月在手术治疗的52例SAP并发PPC患者临床资料,其中31例行内镜联合腹腔镜手术治疗(内镜-腹腔镜组),21例行采用开腹手术治疗(开腹组)。比较两组患者术中治疗情况、术后疗效、恢复及并发症发生的情况。结果:内镜-腹腔镜组手术时间、术中出血量、术后排气时间及术后住院时间均明显少于开腹组(均P<0.05);两组治疗有效率和术后并发症发生率差异无统计学意义(均P>0.05);内镜-腹腔镜组术后疼痛、恶心、呕吐发生率均明显低于开腹组(均P<0.05)。随访半年后,两组患者均无PPC复发。结论:采用内镜联合腹腔镜治疗SAP并发PPC,疗效显著,安全性好,可根据患者具体情况形成个体化治疗策略,值得临床应用。

Objective：To investigate the clinical efficacy of endoscopic plus laparoscopic treatment for severe acute pancreatitis（SAP） complicated by pancreatic pseudocyst（PPC）.Methods：The clinical data of 52 patients with SAP and PPC undergoing surgical treatment from June 2012 to March 2014 were collected.Of the patients,31 cases underwent endoscopic plus laparoscopic treatment（endoscopic-laparoscopic group）,and 21 cases were subjected to open surgery（open surgery group）.The intraoperative conditions,postoperative outcome and recovery as well as incidence of complications were compared between the two groups.Results：In endoscopic-laparoscopic group,the operative time,intraoperative blood loss,time to first flatus and length of postoperative hospital stay were significantly decreased compared with open surgery group（all P0.05）.There was on statistical difference in treatment efficacy rate and incidence of postoperative complications between the two groups（both P0.05）.The incidences of postoperative pain,nausea and vomiting in endoscopiclaparoscopic group were significantly lower than those in open surgery group（all P0.05）.Postoperative followup was conducted for 6 months,and no PPC recurrence was noted in any of the two groups.Conclusion：Endoscopic plus laparoscopic procedure has remarkable efficacy and better safety in treatment of SAP with PPC,and individualized treatment strategies can be formulated according to the specific condition of patients.So it is recommended to be used in clinical practice.