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目的观察、探讨腹腔镜联合十二指肠镜治疗急性胆源性胰腺炎伴胆囊结石的效果及手术时机的选择。方法回顾性分析118例急性胆源性胰腺炎伴胆囊结石患者的临床资料。据手术方式不同分为腹腔镜联合十二指肠镜组(观察组)58例与传统开腹组(对照组)60例。比较2组治疗效果、术中及术后情况、并发症发生率及病死率等。结果观察组腹痛缓解时间、超敏C反应蛋白恢复时间、血清淀粉酶恢复时间、肝功能恢复时间、住院时间均明显短于对照组(P<0.05);观察组并发症发生率8.6%,明显低于对照组的25.0%(P<0.05);2组病死率比较差异无统计学意义(P>0.05)。结论腹腔镜联合十二指肠镜治疗急性胆源性胰腺炎伴胆囊结石的效果显著,并发症发生率较传统开腹手术低,值得临床推广应用。
Objective To observe and discuss the effect of laparoscopic combined with duodenoscopy in the treatment of acute gallstone pancreatitis with gallstone and the choice of operation timing. Methods The clinical data of 118 patients with acute gallstone pancreatitis and gallstone were retrospectively analyzed. According to different surgical methods were divided into laparoscopic combined duodenoscopy group (observation group) 58 cases and the traditional open group (control group) 60 cases. The therapeutic effects, intraoperative and postoperative complications, incidence of complications and mortality were compared between the two groups. Results The pain relief time, hsCRP recovery time, serum amylase recovery time, liver function recovery time and hospital stay in the observation group were significantly shorter than those in the control group (P <0.05). The complication rate in the observation group was 8.6% Which was lower than 25.0% of the control group (P <0.05). There was no significant difference in mortality between the two groups (P> 0.05). Conclusions Laparoscopy combined with duodenoscopy has a significant effect in the treatment of acute gallstone pancreatitis with gallstone. The complication rate is lower than traditional laparotomy, which is worthy of clinical application.