早期腹腔镜胆囊切除治疗急性胆源性胰腺炎的疗效观察

刘会侠，桂普国

（杨凌示范区医院，陕西 咸阳，712100）

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摘要：

目的 探讨早期腹腔镜胆囊切除治疗急性胆源性胰腺炎的临床疗效。方法 选取2014年1月至2016年12月我院普外科接收治疗的100例行腹腔镜胆囊切除术的急性胆源性胰腺炎患者作为研究对象，按手术时机分为研究组和对照组，每组50例。对照组于初次发病后1个月行腹腔镜胆囊切除术治疗，研究组于发病后48 h内（早期）进行腹腔镜胆囊切除术治疗，比较两组患者的并发症发生情况、手术时间、住院时间、治疗费用、术后肛门排气时间及病情复发情况。结果 两组患者经治疗后均康复出院，无死亡病例，手术无中转开腹情况。对照组并发症总发生率为12.0%，高于研究组的4.0%（P<0.05）。两组患者手术时间、术后肛门排气时间比较，差异不显著（P>0.05）；研究组的住院时间、治疗费低于对照组（P<0.05）。两组患者随访10个月，无胰腺炎复发。结论 相比于延期胆囊切除术，早期手术具有住院费用低、住院时间短，并发症少，病情复发率低等优点，值得临床推广应用。

关键词：早期腹腔镜胆囊切除；急性胆源性胰腺炎；并发症

中图分类号：R657.4文献标志码：A文章编号：2096-1413(2017)14-0073-02

Clinical effect observation of early laparoscopic cholecystectomy on acute pancreatitis
LIU Hui-xia, GUI Pu-guo
(Yangling Demonstration Zone Hospital, Xianyang 712100, China)

ABSTRACT：Objective To investigate the clinical effect of early laparoscopic cholecystectomy on acute pancreatitis.Methods One hundred cases of patients with acute pancreatitis treated with laparoscopic cholecystectomy in our hospital from January 2014 to December 2016 were selected. All the patients were divided into control group and research group according to the operation time, with 50 cases in each group. The control group was treated with laparoscopic cholecystectomy after one month of onset, while the research group was treated with laparoscopic cholecystectomy within 48 hours after onset. The complications, operation time, hospitalization time, treatment costs, postoperative anal exhaust time and recurrence of the two groups were compared. Results Patients in the two groups were discharged after treatment, with no deaths and no conversion to open surgery. The total incidence rate of complications of the control group was 12.0%, which was higher than 4.0% of the research group (P<0.05). There was no significant difference between the two groups in the time of operation and postoperative anal exhaust time (P>0.05), However, the hospitalization time and treatment cost of the research group were significantly shorter than those of the control group (P<0.05). After 10 months of follow-up, there was no recurrence of pancreatitis case in the two groups. Conclusion Compared with the delayed cholecystectomy, early laparoscopic cholecystectomy has the advantages of lower cost, shorter hospitalization time, less complications and lower recurrence rate, which is worthy of clinical application.
KEYWORDS: early laparoscopic cholecystectomy; acute pancreatitis; complications

参考文献：
[1] 田青,张雅敏.腹腔镜胆囊切除前后急性胆源性胰腺炎的临床特征分析[J].山东医药,2015,55(4):55-57.
[2] 董德福.早期腹腔镜胆囊切除治疗轻症急症胆源性胰腺炎的疗效观察[D].太原:山西医科大学,2016.
[3] 聂辉.早期腹腔镜胆囊切除术治疗胆囊结石所致急性胆源性胰腺炎的可行性探讨[J].中国疗养医学,2016,25(8):836-838.
[4] 董德福,梁建伟,何若冲.早期腹腔镜胆囊切除治疗轻症急症胆源性胰腺炎的疗效观察[J].当代医学,2016,22(20):3-5.
[5] 赵玉沛.胆源性胰腺炎诊断标准与处理原则的探讨[J].中华肝胆外科杂志,2002,8(2):95-96.
[6] 刘习庚.不同手术时机治疗胆源性急性胆源性胰腺炎的临床效果对比分析[J].现代诊断与治疗,2013,24(1):30-31.
[7] 马超.不同手术时机治疗胆源性急性胆源性胰腺炎的临床效果对比分析[J].吉林医学,2011,32(30):6331.
[8] 白麟.急性胆源性胰腺炎快速康复治疗探讨:附62例病例分析[D].长春:吉林大学,2013.
[9] 孙备,孔瑞.胆源性胰腺炎的诊治[J].肝胆外科杂志,2006,14(3):234-235.


[10] 曾录万.胆囊结石合并急性胆源性胰腺炎患者早期腹腔镜胆囊切除术的疗效观察[J].肝胆外科杂志,2016,3(12):2275-2276.
[11] 唐海生.急性胆源性胰腺炎早期行胆囊切除的治疗观察[J].大家健康:学术版,2015,9(4):119-120.
[12] 孙康,党胜春,瞿建国,等.急性胆源性胰腺炎患者腹腔镜胆囊切除手术最佳时机探讨[J].山东医药,2014,54(18):33-35.