胆囊结石并发胆源性胰腺炎行腹腔镜胆囊切除术的临床疗效分析

目的探讨腹腔镜胆囊切除术(LC)治疗胆囊结石并发胆源性胰腺炎(ABP)的临床疗效。方法回顾分析我院2012年6月至2013年12月收治的48例胆囊结石并发胆源性胰腺炎患者实施腹腔镜胆囊切除术或开腹胆囊切除术治疗的临床资料。结果本组48例患者经保守治疗3~12天,患者临床症状(腹痛、体温)及实验室检查(血常规、肝功能、淀粉酶)好转,患者病情逐渐稳定,并逐渐恢复半流质饮食,患者腹部体征基本消失,取得满意效果。48例患者均行胆囊切除术,术后均无大出血,胆管损伤,胆瘘等并发症的发生,术后无胰腺炎的发生,患者均痊愈出院。在3周后实施LC的成功率高于3周内手术患者。术后随访2个月~12个月,均无胰腺炎复发,无胆总管结石发生。结论胆囊结石并发急性胰腺炎患者,首先应针对胰腺炎进行治疗。待患者病情逐渐稳定,3周后行腹腔镜胆囊切除术安全可靠。

Clinical analysis of cholecystolithiasis compliacted with acute biliary pancreatitis treated by Laparoscopic cholecystectomy

Objective Analysis of laparoscopic cholecystectomy（LC） in treatment of cholecystolithiasis compliacted with acute biliary pancreatitis（ABP）. Methods Rertospectively analysis the 48 patients with cholecystolithiasis compliacted with acute biliary pancreatitis hospitalized in our hospital during 2012 June to 2013 December,who took the operation of laparoscopic cholecystectomy or open cholecystectomy. Results The group of 48 patients were treated conservatively,and the symptoms were relieved in 3 - 12 days. All of them took the cholecystetomy when the symptoms were relieved,all recovered well after the operation,no postoperative bleeding,bile duct injury,biliary fistula,and no relapse of the pancreatitis occured. Until the patient＇s condition gradually stabilized,three weeks underwent laparoscopic cholecystectomy safe and reliable. Conclusion When a patient is suffering from cholecystolithiasis compliacted with acute biliary pancreatitis,focus on the non-operational treatments to the pancreatitis. Do the operation of LC or OC when the symptoms were relieved after 3 weeks.