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目的分析胆源性急性胰腺炎行腹腔镜胆囊切除术的手术时机。方法选取2015年1月-2016年1月胆源性急性胰腺炎行腹腔镜胆囊切除术患者84例,将其随机分为2组,每组42例,所有患者术前均接受保守治疗控制炎症和病情,在此基础上,早期组在1周内进行腹腔镜胆囊切除术治疗;延期组在1~2周内进行腹腔镜胆囊切除术治疗。比较2组患者手术操作时间、出血量、术后肛门恢复排气时间、术后康复时间、治疗总有效率、并发症发生率和1年复发率。结果早期组患者手术操作时间、出血量、术后肛门恢复排气时间、术后康复时间均明显短于/低于延期组,差异均有统计学意义(P<0.05)。2组治疗总有效率、并发症发生率和1年复发率比较差异均无统计学意义(P>0.05)。结论胆源性急性胰腺炎行腹腔镜胆囊切除术的手术时机选择在炎症得到控制后的1周内,可缩短手术操作时间,减少出血,加快术后康复进程,缩短住院时间,值得临床推广。
Objective To analyze the timing of laparoscopic cholecystectomy for biliary acute pancreatitis. Methods From January 2015 to January 2016, 84 patients with gallstone-derived acute pancreatitis undergoing laparoscopic cholecystectomy were randomly divided into 2 groups (42 in each group). All patients received conservative treatment before operation to control inflammation And the condition, on this basis, the early group laparoscopic cholecystectomy within 1 week; deferred group laparoscopic cholecystectomy within 1 to 2 weeks. The operation time, blood loss, anus recovery exhaust time, postoperative recovery time, total effective rate of treatment, complication rate and 1 year recurrence rate were compared between the two groups. Results The operation time, hemorrhage volume, postoperative anus recovery exhaust time and postoperative recovery time were significantly shorter in early group than in late group (P <0.05). There was no significant difference between the two groups in the total effective rate, the complication rate and the one-year recurrence rate (P> 0.05). Conclusions Choosing the timing of operation for laparoscopic cholecystectomy in patients with gallstone-derived acute pancreatitis can shorten the operation time, reduce the bleeding, accelerate the postoperative rehabilitation process and shorten the length of hospital stay, which is worthy of clinical promotion within one week after the inflammation is controlled.