摘要
目的 探讨对急性胰腺炎（AP）合并胆总管结石早期行腹腔镜联合胆道镜治疗方式的可行性.方法 分析我院2007年1月至2009年11月收治的102例AP合并胆总管结石患者.研究组43例,均早期（入院72 h内）行腹腔镜下胆囊切除、胆总管切开取石T管引流术加术中胆道镜取石术;其中13例还行胰腺被膜切开加腹腔灌洗引流.对照组59例,先均行保守治疗.其中46例在胰腺炎明显好转后,才行腔镜手术;另9例出现重症胆管炎、4例胰周感染时,行急诊开腹手术.结果 两组比较,在胃肠道功能恢复时间、淀粉酶恢复时间、住院时间及住院费用比较差异均有统计学意义 （P〈0.05）.结论 对AP合并胆总管结石患者早期实施腹腔镜联合胆道镜干预是一种创伤小、恢复快、安全有效的方法.
Objective To explore the feasibility and validity of laparoscopic choledochotomy and choledochoscopy for treament of patients with acute pancreatitis accompanying commom bile duct stones. Methods A total of 102 patients acute pancreatitis accompanying common bile duct gall stones were treated in our institution between January 2007 and November 2009. Among them, 43 patients underwent laparoscopic choledochotomy and choledochoscopy within 72h after admission entered our study group. They all had a laparscopic cholecystectomy and choleldochotomy and choledochoscopy to retrieve common bile duct stones. Of these, 13 patients undergoing pancreatic capsule incision and peritoneal lavage. Fifty-nine patients undergoing traditional conservative treatment firstly were used as a control group. Of these, 46 were performed laparscopic surgery and choledochotomy after smoothly recovery from pancreatitis. 13 underwent emergency open operation due to complications of pancreatitis. Results In the gastrointestinal function recovery time, amylase recovery time, length of stay and hospitalization cost, there was a significant difference between study group and the control group （P〈0.05）. Conclusions Our study provides evidence for the good clinical efficacy of early implementation of laparoscopic choledochotomy and choledochoscope for treatment of choledocholithiasis and acute pancreatitis.
出处
《中华内分泌外科杂志》
CAS
2010年第3期170-172,175,共4页
Chinese Journal of Endocrine Surgery
基金
四川省教育厅科研资助项目（2005.A087）
关键词
急性胰腺炎
腹腔镜
胆道镜
胆总管结石
Acute pancreatitis
Laparoscopy
Choledochoscopy
Common bile duct gall stones
