急性胆源性胰腺炎腹腔镜胆囊切除术手术时机选择

目的探讨急性胆源性胰腺炎(ABP)实施腹腔镜胆囊切除术的最佳手术时机。方法选取医院2017年5月至2019年6月收治的行腹腔镜胆囊切除术的ABP患者92例,按入院顺序分为对照组(入院后立即手术)和观察组(先保守治疗,待胰腺炎症状明显缓解,血尿淀粉酶及胆红素等指标恢复至正常水平,再行手术),各46例。结果观察组总有效率为93.48%,显著高于对照组的80.43%(P<0.05);观察组患者的手术时间、术后肛门排气时间和住院天数显著短于对照组,术中出血量显著少于对照组,中转开腹率显著低于对照组(P<0.05)。结论临床应先对ABP患者展开保守治疗,待有效缓解胰腺炎症状后,再行腹腔镜胆囊切除术,可缩短患者术后恢复时间。

Objective To investigate the best opportunity of laparoscopic cholecystectomy for acute gallstone pancreatitis(ABP).Methods Totally 92 patients with ABP underwent laparoscopic cholecystectomy from May 2017 to June 2019 were divided into the control group(immediate operation after admission)and the observation group(The patients were treated conservatively first,and then operation was performed after the symptoms of pancreatitis were relieved and the levels of amylase and bilirubin in blood and wrine returned to normal)according to the order of admission,46 cases in each group.Results The effective rate of the observation group was 93.48%,which was significantly higher than 80.43%of the control group(P<0.05).The operation time,anal exhaust time and hospitalization days of the observation group were significantly shorter than those of the control group,the intraoperative bleeding volume was significantly less than that of the control group,and the conversion rate of laparotomy was significantly lower than that of the control group(P<0.05).Conclusion The patients with ABP should be treated conservatively,and then laparoscopic cholecystectomy should be performed when the sympotoms of pancreatitis are obviously relieved,which can shorten the recovery time.