轻症急性胆源性胰腺炎腹腔镜胆囊切除手术时机的探讨

发布时间：2018-06-28 02:35

  本文选题：急性胆源性胰腺炎 + 腹腔镜　； 参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨轻症急性胆源性胰腺炎行腹腔镜胆囊切除术的手术时机,以评价手术治疗的安全性和可行性。方法:回顾性分析2013年1月至2016年8月期间于笔者所在医院收治的92例轻型急性胆源性胰腺炎(Ranson评分3)患者的临床资料,根据患者行腹腔镜胆囊切除术(LC)前的病程分为早期手术组(n=47,本次入院的病程2周内行LC)与择期手术组(n=45,出院后病程6-8周后再次入院行LC)。早期手术组47例中38例行LC,9例分期行ERCP+EST+ENBD+LC。择期手术组45例均行LC,其中10例在急性期行ERCP+EST+ENBD。比较2组患者手术效果相关性指标及并发症发生情况。结果:早期手术组和择期手术组患者的术区粘连例数、留置腹腔引流管、术后住院时间、术后并发症发生和术后胰腺炎复发比较差异无统计学意义(P0.05),但2组患者的手术时间和术中出血量比较差异有统计学意义(P0.05)。结论:轻症急性胆源性胰腺炎患者在本次住院病程2周内行腹腔镜胆囊切除术是安全、可行的,值得推广。
[Abstract]:Objective: to evaluate the safety and feasibility of laparoscopic cholecystectomy in patients with mild acute biliary pancreatitis. Methods: the clinical data of 92 patients with mild acute biliary pancreatitis (Ranson score 3) treated in our hospital from January 2013 to August 2016 were analyzed retrospectively. According to the course of laparoscopic cholecystectomy (LC), the patients were divided into early operation group (n = 47) and selective operation group (n = 45). In the early operation group, 38 cases were treated with LCV and 9 cases were treated with ERCP EST ENBD LC. In the elective operation group, 45 cases were treated with LCL, and 10 cases were treated with ERCP EST ENBD in the acute phase. Objective: to compare the correlation index of operation effect and the occurrence of complications between the two groups. Results: the patients in the early operation group and the selective operation group were treated with intraperitoneal drainage tube, the postoperative hospitalization time, the number of adhesions in the operation area, There was no significant difference between postoperative complications and postoperative pancreatitis recurrence (P0.05), but the operative time and intraoperative bleeding volume were significantly different between the two groups (P0.05). Conclusion: laparoscopic cholecystectomy is safe, feasible and worth popularizing in patients with mild acute biliary pancreatitis.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.4

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