目的 探讨不同时期腹腔镜胆囊切除术(LC)治疗轻症急性胆源性胰腺炎(ABP)的效果及安全性.方法 选取2013年12月至2016年12月在陕西省人民医院确诊为轻症ABP而行LC治疗的患者100例,依据LC时间分为早期组和择期组,每组50例.早期组患者确诊后72 h内行腹腔镜胆囊切除术;择期组患者择期2～6周后行腹腔镜胆囊切除术.所有患者术后通过电话及复诊等方式随访3个月.比较2组患者的手术难度、手术时间、肛门排气时间、住院时间、住院费用、并发症、复发及死亡情况.结果 2组手术难度、手术时间、肛门排气时间比较,差异均无统计学意义(均P ＞0.05).择期组住院时间明显长于、住院费用明显高于早期组[(28.5±3.1)d比(13.7±2.0)d、(8.1±0.8)万元比(5.7±0.6)万元],差异均有统计学意义(均P＜0.01).早期组和择期组并发症发生率、复发率比较,差异均无统计学意义(均P＞0.05).结论 与择期LC比较,早期LC不会增加轻症ABP患者的手术难度和并发症风险,也具有良好的临床疗效,且可降低患者的住院时间和费用.%Objective To analyze efficacy and safety of different time laparoscopic cholecystectomy (LC) on mild acute biliary pancreatitis(ABP).Methods Totally 100 patients with mild ABP who had LC from December 2013 to December 2016 in Shaanxi Provincial People's Hospital were divided into early operation group and selective operation group,with 50 cases in each group.The early operation group had LC in 72 h after diagnosis of ABP;the selective operation group had LC in 2-6 weeks;all patients were followed up for 3 months after operation.Surgical difficulty,operation duration,anal exhaust time,hospital stay time,medical expense,complications,recurrence and death were analyzed.Results Surgical difficulty,operation time and anal exhaust time had no significant differences between groups(P ＞ 0.05).Hospital stay time was longer and medical expense was more in selective operation group than those in early operation group[(28.5 ± 3.1) d vs (13.7 ± 2.0) d,(81 ± 8) thousand yuan vs (57 ± 6) thousand yuan],the differences were significant (P ＜ 0.01).Complication rate and recurrence rate had no significant differences between early operation group and selective operation group [18.0％(9/50) vs14.0％(7/50),6.0％(3/50) vs8.0％(4/50)](P＞0.05).Conclusion EarlyLChas advantages of shorter hospital stay time and less medical expense compared to selective LC in treating mild ABP without increasing surgical difficulty and complication risk.
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