早期腹腔镜胆囊切除术在急性胆源性胰腺炎中的应用

Application of early laparoscopic cholecystectomy in acute biliary pancreatitis

目的探讨早期腹腔镜胆囊切除术治疗急性胆源性胰腺炎的疗效。方法回顾性分析2005年1月至2014年4月我院收治的急性胆源性胰腺炎患者共136例,根据手术选择时间,分为早期手术组(ELC组,入院后5 d内行LC)76例和择期手术组(ILC组,出院1个月以上择期行LC)60例,比较两组在手术难度、手术时间、中转开腹率、术后并发症发生率、住院天数和费用的不同。结果 ELC组和ILC组在手术难度、手术时间、中转开腹率、术后并发症发生率上并没有统计学差异(P>0.05),而ELC组的住院天数和住院费用明显低于ILC组(P<0.05),且ILC组有35.0%的患者在等待手术过程中因胆源性胰腺炎复发入院。结论对于急性胆源性胰腺炎患者,早期施行LC术并没有增加手术难度、手术时间、中转开腹率和术后并发症发生率,相反大大降低了住院时间和住院费用。

Objective To explore the curative effects of the early laparoscopic cholecystectomy（ELC） in acute biliary pancreatitis（ABP）. Methods A retrospective study was performed on 136 cases of ABP from Jan.2005 to Apr. 2014 in our hospital. Cases of ABP underwent LC within 5 d and within 1 mon were assigned to early laparoscopic cholecystectomy group（ELC, n=76） and interval laparoscopic cholecystectomy group（ILC,n=60） respectively. The difficulty, operating time, incidence of conversion, post-operative complication rate, hospital stay and hospitalization expense were performed to compare the difference between ILC and ELC group.Results There was no significant difference between ILC and ELC group in terms of the difficulty of LC, operating time, incidence of conversion and post-operative complication rate（P〉0.05）. Whereas the hospital stay and hospitalization expense was significantly lower in ILC than those in ELC（P〈0.05）. A total of 35.0% patients in ILC group re-admitted to hospital in waiting for surgery because of recurrence of ABP. Conclusion Early laparoscopic cholecystectomy do not increase the difficulty of LC, operating time, incidence of conversion and postoperative complication rate for patients with ABP, on the contrary which can greatly reduce the hospital stay and hospitalization expense.