摘要
目的研究不同时间窗行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗轻症胆源性胰腺炎的临床疗效。方法采用数字随机表法随机选取2012年2月~2020年2月我院诊断为轻症胆源性胰腺炎并行LC病人80例。入院后根据病人实施手术时间分为早期手术组和后期手术组,每组各40例,其中,病人腹痛症状部分缓解后行LC治疗的为早期手术组,腹痛症状完全缓解后行LC治疗的为后期手术组,比较两组病人的临床疗效。结果两组病人术前平均发病时间分别为(3.73±0.78)天和(6.88±1.07)天,两组比较差异有统计学意义(P<0.05);早期手术组和后期手术组中转开腹手术率分别为5.0%和7.5%,手术时间分别为(72.92±10.48)分钟和(74.02±9.94)分钟,术后并发症发生率分别为5.0%和2.5%,两组比较差异无统计学意义(P>0.05);与早期手术组相比,后期手术组病人的术中出血量减少[(42.13±12.90)ml vs.(35.25±13.01)ml,]、住院时间延长[(7.73±0.78)天vs.(10.88±1.07)天]及住院费用增多[(24553.91±3946.91)元vs.(27617.96±4276.29)元],两组比较差异有统计学意义(P<0.05);两组病人胆囊三角解剖难度虽然增加,但中转开腹手术率差异无统计学意义(P>0.05)。结论轻症胆源性胰腺炎尽早行手术治疗没有增加病人围手术期的并发症及中转开腹手术率,但可缩短住院时间,减轻经济负担。
Objective To study the clinical efficacy of laparoscopic cholecystectomy under different time windows in the treatment of mild biliary pancreatitis.Methods A total of 80 patients who were admitted with a diagnosis of mild biliary pancreatitis and underwent laparoscopic cholecystectomy at Nanjing Tongren hospital affiliated medical college of southeast university between February 2012 and February 2020 were selected randomly by digital random table method.After admission,Patients were divided into early surgery group and late surgery group according to operation time,with 40 cases in each group abdominal pain symptoms.Among them,LC treatment was performed after partial relief of abdominal pain in patients in the early surgery group,and LC treatment was performed after complete relief of abdominal pain in patients in the late surgery group.The clinical efficacy of the two groups was compared.Results The mean preoperative onset time between the two groups[(3.73±0.78)days vs.(6.88±1.07)days],and the difference was statistically significant(P<0.05).The conversion rate of open operation(5.0%vs.7.5%),operation time[(72.92±10.48)minutes vs.(74.02±9.94)minutes]and incidence of postoperative complications(5.0%vs.2.5%),there was no statistical significance between the two groups(P>0.05).Compared with the early surgery group,patients in the late surgery group had less intraoperative blood loss[(42.13±12.90)ml vs.(35.25±13.01)ml]and longer hospital stay[(7.73±0.78)days vs.(10.88±1.07)days]and increased hospitalization costs[(24553.91±3946.91)yuan vs.(27617.96±4276.29)yuan](all P<0.05).Although the difficulty of gallbladder triangle anatomy increased between the two groups,there was no significant difference in the rate of conversion to open surgery(P>0.05).Conclusion Early surgery for mild biliary pancreatitis does not increase the perioperative complications and the conversion rate to open surgery,but it can significantly shorten the length of hospital stay,and reduce the economic burden of patients.
作者
彭靖
王飞
王春
慕海峰
PENG Jing;WANG Fei;WANG Chun(Department of General Surgery,Nanjing Tongren Hospital Affiliated Medical College of Southeast University,Jiangsu,Nanjing 211100,China)
出处
《临床外科杂志》
2022年第11期1034-1036,共3页
Journal of Clinical Surgery
关键词
轻症胆源性胰腺炎
腹腔镜胆囊切除
手术时机
mild biliary pancreatitis
laparoscopic cholecystectomy
time of operative
作者简介
通信作者:慕海峰,Email:muhf@njtrh.org。
