腹腔镜胆囊切除术治疗胆囊结石合并胆源性重症急性胰腺炎的可行性探讨

摘要

目的：分析腹腔镜胆囊切除术（LC）治疗胆囊结石合并胆源性重症急性胰腺炎（SABP）的可行性。方法选择2011年11月至2015年1月广元市第三人民医院收治的120例胆囊结石合并SABP患者，将其按随机数字表法分为对照组（60例）和观察组（60例）。对照组患者实施开腹手术治疗，观察组患者实施LC治疗。比较两组患者术中出血量、手术时间等各项指标及术后并发症发生情况。结果观察组手术时间短于对照组[（112.3±22.4） min 比（154.6±23.7） min]，排气时间短于对照组[（30.2±3.4） h 比（41.6±4.2） h]，术中出血量少于对照组[（142.4±20.5） mL 比（253.8±30.7） mL]，住院时间短于对照组[（4.2±3.4） d比（8.9±6.6） d]，差异均有统计学意义（P＜0.01）。观察组患者的并发症发生率为11.67％（7／60），低于对照组患者的26.67％（16／60），差异有统计学意义（ P＜0.05）。结论在胆囊结石合并 ABSP的治疗中，实施 LC手术治疗，可以缩短患者的手术时间，减少术中出血量，同时提高患者的康复速度，缩短患者的住院时间，还可以有效地减少并发症的发生，安全性较高，具有可行性。%Objective To discuss the feasibility of 1aparoscopic cholecystectomy( LC) for gallbladder stone with severe acute biliary pancreatitis(SABP).Methods Total of 120 patients with gallbladder stone with SABP in Guangyuan City Third People′s Hospital during Nov.2011 and Jan.2015 were included in the study,the patients were randomly divided into a control group ( 60 cases) and an observation group ( 60 cases).The control group received laparotomy,while the observation group received LC treatment.The intrao-perative blood loss,the operation time and the postoperative complications of the two groups were observed and compared.Results The operation time of the observation group was shorter than the control group [ (112.3 ±22.4 ) min vs ( 154.6 ±23.7 ) min ]; exhaust time i was shorter than the control group [(30.2 ±3.4) h vs (41.6 ±4.2) h];blood loss was less than the control group[(142.4 ±20.5) mL vs (253.8 ±30.7) mL];length of hospital stay was shorter than the control group[(4.2 ±3.4) d vs (8.9 ± 6.6) d],the difference was statistically significant (all P<0.01).Complication incidence of the observa-tion group was 11.67%(7/60),lower than 26.67%(16/60) of the control group,the difference was statis-tically significant(P <0.05).Conclusion In the treatment of gallbladder stone with SABP,LC surgery treatment,can shorten the operation time,reduce the intraoperative blood loss,improve the recovery speed,, reduce the hospital stay, and effectively reduce the occurrence of complications, with high safety, thus is feasible.