腹腔镜联合胆道镜胆总管探查切开取石术治疗胆石症所致急性胆源性胰腺炎的临床效果

Clinical effect of laparoscopic common bile duct exploration in the treatment of acute biliary pancreatitis caused by cholelithiasis

目的探究腹腔镜联合胆道镜胆总管探查切开取石术(LCBDE)治疗胆石症所致急性胆源性胰腺炎(ABP)的临床效果。方法选取2012年11月至2016年11月我院收治的70例胆石症所致ABP患者,依据治疗方案的不同将其分为对照组与试验组,各35例。对照组行开腹胆总管切开T管引流术(OCTD)治疗,试验组行LCBDE治疗。比较两组的手术相关指标、术后恢复情况及并发症发生情况。结果两组患者手术成功率、手术时间比较,差异无统计学意义(P>0.05);试验组术后下床活动时间、胃肠功能恢复时间及引流管拔除时间均短于对照组,差异有统计学意义(P<0.05)。试验组C反应蛋白、血清淀粉酶恢复时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。试验组术后并发症总发生率为2.86%,低于对照组的25.71%,差异有统计学意义(P<0.05)。两组均随访4~24个月,平均(14.02±4.98)个月。随访结果显示,两组均无手术并发症或(和)胆道结石及胰腺炎复发。结论 LCBDE术治疗胆石症所致的ABP效果显著,可显著降低并发症发生率,促进患者术后康复,且安全性高。

Objective To investigate the clinical effect of laparoscopic common bile duct exploration (LCBDE) in thetreatment of acute biliary pancreatitis (ABP) caused by cholelithiasis. Methods From November 2012 to November 2016,70 patients with ABP caused by cholelithiasis admitted in our hospital were selected and divided into control group andexperimental group according to different treatment plan, with 35 cases in each group. The control group underwent opencholedocholithotomy T -tube drainage (OCTD), and the experimental group underwent LCBDE. The relevant surgicalindicators, postoperative recovery and complications were compared between the two groups. Results There were nosignificant differences in the success rate and time of operation between the two groups (P >0.05). The time ofpostoperative activity, gastrointestinal function recovery and drainage tube removal in the experimental group were shorterthan those in the control group, and the differences were statistically significant (P<0.05). The recovery time of Creactiveprotein and serum amylase and hospitalization time in the experimental group were shorter than those in thecontrol group, and the differences were statistically significant (P <0.05). The total incidence of postoperativecomplications in the experimental group was 2.86%, which was lower than the 25.71% in the control group, and thedifferences were statistically significant (P<0.05). Both groups were followed up for 4-24 months, with an average of(14.02±4.98) months. Follow-up results showed that there were no operative complications or recurrence of biliary calculiand pancreatitis in both groups. Conclusion LCBDE is effective in the treatment of ABP caused by cholelithiasis, whichcan significantly reduce the incidence of complications and promote the recovery of patients after operation, with high safety.