一期与延期行腹腔镜胆囊切除术治疗急性胆源性胰腺炎的疗效

Therapeutic effect of one-stage and delayed laparoscopic cholecystectomy for acute biliary pancreatitis

目的探讨一期与延期行腹腔镜胆囊切除术治疗急性胆源性胰腺炎的临床疗效。方法收集在我院行腹腔镜胆囊切除术治疗的急性胆源性胰腺炎患者150例,按照手术时间分为观察组和对照组,各75例。观察组采用一期腹腔镜胆囊切除术(首次住院时间内手术),对照组采用延期腹腔镜胆囊切除术(胰腺炎控制后2个月,再次入院手术),比较两组患者的临床效果。结果两组患者的手术时间、手术出血量、术后排气时间及术后半年复发率比较,差异无统计学意义(P>0.05);观察组患者的累积住院时间及累积治疗费用明显少于对照组(P<0.05)。两组患者术后1、7 d的AMY、UMY、ALT+AST及AKP水平、生活质量各项评分比较,差异无统计学意义(P>0.05)。结论对急性胆源性胰腺炎一期行腹腔镜胆囊切除术的疗效满意,且能够缩短患者的住院时间和减少费用。

Objective To evaluate the clinical efficacy of one-stage and delayed laparoscopic cholecystectomy for acutegallstone pancreatitis. Methods A total of 150 patients with acute biliary pancreatitis who underwent laparoscopiccholecystectomy were divided into observation group and control group according to the operation time, with 75 cases in eachgroup. The observation group was treated with one-stage laparoscopic cholecystectomy （operated in first hospital stay） and thecontrol group was treated with delayed laparoscopic cholecystectomy （2 months after control of pancreatitis, and thenadmitted to hospital again and received operation）. The clinical effects of the two groups were compared. Results There wereno significant differences in operation time, bleeding volume, postoperative venting time and postoperative half -yearrecurrence rate between the two groups （P〉0.05）. The cumulative hospitalization time and cumulative treatment cost in theobservation group were significantly better than those in the control group （P〈0.05）. There were no significant differences inthe levels of AMY, UMY, ALT＋AST and AKP after 1 and 7 d of surgery, scores of quality of life between the two groups（P〉0.05）. Conclusion One -stage laparoscopic cholecystectomy for patients with acute biliary pancreatitis has satisfactoryefficacy, which can reduce the hospitalization time and cost of patients.