轻度胆源性急性胰腺炎患者胆囊切除时机探讨

Timing of cholecystectomy in patients with mild biliary acute pancreatitis

目的 探讨轻度胆源性急性胰腺炎胆囊切除时机.方法 前瞻性收集轻度胆源性急性胰腺炎患者80例,采用随机数字表原则分为研究组和对照组,每组各40例,研究组早期行胆囊切除术,对照组晚期行胆囊切除术.主要观察指标包括胆道相关并发症、围手术期并发症、中转开腹手术率、手术时间和总住院时间.结果 与对照组比较,研究组总住院时间显著缩短[（9.39±2.48）d比（11.48±3.28）d,t=3.582,P=0.000].两组中转剖腹手术率、手术时间、围手术期相关并发症和病死率等差异无统计学意义（P＞0.05）.研究组急性胆囊炎、胆绞痛发作和总胆道相关并发症发生率分别为0.00%、0.00%和0.00%,显著低于对照组的15.00%、22.50%和47.50%（x2=4.505、8.013和22.364,P=0.034、0.005和0.000）.结论 早期腹腔镜下胆囊切除术有助于降低胆道系统不良事件发生率.

Objective To investigate the timing of cholecystectomy in patients with mild biliary acute pancreatitis.Methods 80 patients with mild acute biliary pancreatitis were prospectively collected.According to the principle of random digital table, the patients were randomly divided into the study group and control group,40 cases in each group.The study group underwent early cholecystectomy, while the control group received delayed cholecystectomy.Main indicators included biliary tract complications, perioperative complications, conversion to open surgery, operation time and total hospital stay were observed.Results Compared with the control group, the total hospitalization time of the study group was significantly shorter[（9.39±2.48）d vs.（11.48±3.28）d,t=3.582,P=0.000].There were no statistically significant differences in the rate of conversion to open surgery, operation time, perioperative complications and mortality between the two groups （P＆gt;0.05）.The incidence rates of acute cholecystitis, biliary colic and total biliary complications of the study group were 0.00%,0.00% and 0.00%, which were significantly lower than those in the control group （15.00%,22.50% and 47.50%） （x2=4.505,8.013 and 22.364,P=0.034,0.005 and 0.000）.Conclusion Early laparoscopic cholecystectomy is helpful to reduce the incidence of adverse events in the biliary system.