腹腔镜序贯外内引流术治疗胰腺假性囊肿的疗效观察

Observation of curative effect of laparoscopic sequential internal and external drainage in the treatment of pancreatic pseudocyst

目的:探讨腹腔镜序贯外内引流术治疗胰腺假性囊肿的临床价值。方法:回顾分析2008年7月至2018年6月收治的56例胰腺假性囊肿患者的临床资料,分为腹腔镜序贯外内引流组(观察组)与经皮穿刺组(对照组),观察两组手术时间、出血量、住院时间、术后带管时间、并发症发生率、短期影像学缓解率、长期影像学缓解率及复发率等情况,评价两种术式的疗效。结果:两组均顺利完成操作,无围手术期死亡,观察组4例同时行腹腔镜胆囊切除术。观察组术后带管时间[(32.69±2.46)d vs.(34.56±2.60)d]、术中出血量[(23.33±5.92)mL vs.(28.69±4.24)mL]、并发症发生率(3.0%vs.26.1%)、长期影像学缓解率(100.0%vs.73.9%)及复发率(0 vs.17.4%)优于对照组,差异有统计学意义。两组短期影像学缓解率(100%vs.91.3%)、住院时间[(8.45±1.06)d vs.(9.95±4.18)d]差异无统计学意义。结论:腹腔镜序贯外内引流术安全、可靠,效果肯定,可作为治疗胰腺假性囊肿的合理术式。

Objective:To investigate the clinical effect of laparoscopic sequential internal and external drainage for the treatment of pancreatic pseudocyst.Methods:From Jul.2008 to Jun.2018,clinical data of 56 patients with pancreatic pseudocyst,who received the treatment of laparoscopic sequential internal and external drainage(observation group)or percutaneous catheter drainage(control group),were retrospectively analyzed.The index including operation time,intraoperative blood loss,length of hospital stay,retaining time of drainage tube,the incidence of postoperative complications,short-term and long-term radiological remission rate and recurrence rat were observed to evaluate the curative effect of two groups.Results:All operations were successful without perioperative death.4 patients in observation group simultaneously underwent laparoscopic cholecystectomy.The retaining time of drainage tube[(32.69±2.46)d vs.(34.56±2.60)d],intraoperative blood loss[(23.33±5.92)mL vs.(28.69±4.24)mL],incidence of postoperative complications(3.0%vs.26.1%),long-term radiological remission rate(100.0%vs.73.9%)and recurrence rat(0 vs.17.4%)in observation group were better than those in control group,there was statistical difference between the two groups.There were no statistical differences between the two groups in short-term radiological remission rate(100%vs.91.3%)or hospital stay[(8.45±1.06)d vs.(9.95±4.18)d].Conclusions:Laparoscopic sequential internal and external drainage is a safe,reliable,effective and rational operation for the treatment of pancreatic pseudocyst.