胆囊结石并发胆源性胰腺炎行腹腔镜胆囊切除术手术时机的探讨

目的探析腹腔镜胆囊切除术(LC)治疗胆囊结石并发胆源性胰腺炎(ABP)的手术时机的临床研究。方法对我院2012年10月至2013年8月胆囊结石并发ABP患者80例,急性胰腺炎轻症(MAP)和重症(SAP)各40例,所有病例均行LC术,A组MAP患者在发病1周内进行LC术,B组在发病1周后行LC术,C组SAP患者在发病3周内行LC术,D组在发病3周后行LC术;比较SAP、MAP各组患者住院费用、时间、术后并发及死亡等情况。结果 MAP患者中,A组的住院费用及住院时间显著低于B组(P<0.05),其他术后并发及死亡情况两组无显著性差异(P>0.05);SAP患者中,D组各项参数指标均显著优于C组(P<0.05)。结论腹腔镜胆囊切除术在治疗胆囊结石并发ABP时,MAP患者在发病后1周内进行手术可靠安全,SAP在发病3周后行LC术可靠安全。

Laparoscopic Cholecystectomy Operation Timing of Cholecystolithiasis Complicated with Biliary Pancreatitis

ObjectiveAnalysis of laparoscopic cholecystectomy（LC）in treatment of cholecystolithiasis complicated with acute biliary pancreatitis（ABP） in clinical research on operation time.MethodsIn our hospital from 2012 October -2013 year in August of cholecystolithiasis complicated with ABP in 80 patients with acute pancreatitis,mild（MAP）and severe（SAP）of the 40 case,all cases under went LC operation, group A MAP were LC in the incidence of 1 weeks, B group 1 week after operation in the pathogenesis of LC, C group SAP patients in the onset of LC patients within 3 week, in group D, the incidence of 3 week after LC operation; comparison of SAP, MAP groups hospitalization cost, time, postoperative complications and death and so.ResultsIn MAP patients, hospitalization expenses andhospitalization time in A group was signiifcantly lower than that in B group（P＆lt;0.05）, with other postoperative and death of two groups had no signiifcant difference （P＆gt;0.05）; patients in SAP group, the D parameters were signiifcantly better than those in C group（P＆lt;0.05）. ConclusionLaparoscopic cholecystectomy in the treatment of cholecystolithiasis complicated with ABP, MAP were safe and reliable in operation 1 weeks after onset, SAP in the pathogenesis of LC is reliable and safe operation after 3 weeks.