急性胆源性胰腺炎手术治疗时机和方法的探讨

Discussion on the timing and method of surgical treatment of acute biliary pancreatitis

目的探究急性胆源性胰腺炎手术治疗的时机和方法。方法选择本院收治的34例急性胆源性胰腺炎患者为研究对象,患者均接受手术治疗,根据手术时机的不同将其分为对照组和观察组,每组17例。对照组入院以后即刻开展经内镜逆行性胰胆管造影术(ERCP)、腹腔镜胆囊切除术联合胆总管探查术治疗,观察组实施保守治疗后开展上述治疗措施。比较两组患者的治疗效果。结果观察组的手术耗时及住院时间均短于对照组,术后引流量少于对照组(P<0.05)。治疗后,观察组淀粉酶和总胆红素水平均显著低于对照组及治疗前(P<0.05)。观察组的术后并发症总发生率显著低于对照组(P<0.05)。结论急性胆源性胰腺炎患者开展手术治疗前实施保守治疗,在炎症缓解以后进行腹腔镜胆囊切除术不仅疗效显著,而且可提升手术的安全性。

Objective To explore the timing and method of surgical treatment of acute biliary pancreatitis. Methods Thirty-four patients with acute biliary pancreatitis admitted in our hospital were selected as the study objects. All patients received surgical treatment. The patients were divided into control group and observation group according to the timing of operation, with 17 cases in each group. The control group received endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic cholecystectomy combined with common bile duct exploration immediately after admission, while the observation group received conservative treatment before implementing the above treatment measures. The treatment effects were compared between the two groups. Results The operation time and hospitalization time of the observation group were shorter than those of the control group, and the postoperative drainage volume was less than that of the control group (P<0.05). After treatment, the levels of amylase and total bilirubin in the observation group were significantly lower than those in the control group and before treatment (P<0.05). The total incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusion In patients with acute biliary pancreatitis, conservative treatment before surgical treatment and laparoscopic cholecystectomy after inflammation relief are not only effective, but also can improve the safety of surgery.