腹腔镜胆囊切除术开展时机对胆囊结石合并急性胰腺炎患者的影响

Effect of the Opportunity for Development of Laparoscopic Cholecystectomy on Patients with Gallstones Complicated with Acute Pancreatitis

目的:探讨腹腔镜胆囊切除术(LC)开展时机对胆囊结石合并急性胰腺炎患者的影响。方法:回顾性分析2020年1月—2022年12月中国贵航集团三0二医院收治的86例胆囊结石合并急性胰腺炎患者的临床资料。根据LC开展时机将其分为观察组和对照组,各43例。对照组给予延期LC,观察组给予早期LC。比较两组围手术期指标,术后恢复情况,术前及术后3 d血清学指标,术前及术后3个月生活质量及并发症。结果:观察组手术时间、住院时间较对照组短,差异有统计学意义(P<0.05)。观察组术后首次肛门排气时间、肠鸣音恢复时间、首次排便时间均早于对照组,差异有统计学意义(P<0.05)。术后3 d,观察组谷丙转氨酶(ALT)、谷草转氨酶(AST)均低于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组生理、心理、社会、环境评分均高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:早期开展LC治疗胆囊结石合并急性胰腺炎效果更佳,可缩短住院时间,加快术后胃肠功能恢复,且并发症少。

Objective:To investigate the effect of the opportunity for development of laparoscopic cholecystectomy on patients with gallstones complicated with acute pancreatitis.Method:The clinical data of 86 patients with gallstones complicated with acute pancreatitis admitted to China Guihang Group 302 Hospital from January 2020 to December 2022 were retrospectively analyzed.According to the opportunity for development of LC,the patients were divided into observation group and control group,with 43 cases in each group.The control group received delayed LC,and the observation group received early LC.Perioperative indexes,postoperative recovery condition,serological indexes before and 3 d after surgery,quality of life before and 3 months after surgery and complications were compared between the two groups.Result:The duration of operation and hospitalization in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The first anal exhaust time,bowel sound recovery time and first defecation time in the observation group were earlier than those in the control group,and the differences were statistically significant(P<0.05).At 3 d after surgery,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 3 months after surgery,the physiological,psychological,social and environmental scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Early LC treatment of gallstones combined with acute pancreatitis has better results,which can shorten the hospital time,and accelerate the recovery of postoperative gastrointestinal function,with fewer complications.