梗阻型急性胆源性胰腺炎两种疗法效果比较

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (571 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To evaluate the clinical effect of laparoscopic common bile duct exploration and ERCP in the treatment of obstructive acute biliary pancreatitis.Methods A retrospective analysis was made of the clinical data of 62 patients with obstructive acute biliary pancreatitis treated in our hospital between March 2010 and May 2014. All the patients had undergone conventional treatment beforemagnetic resonance cholangiopancreatography (MRCP) was used to confirm stones in the common bile duct. Among them, 39 patients received laparoscopic common bile duct exploration (laparoscopic group), and the remaining 23 patients ERCP combined with EST (ERCP group). The postoperative changes in white blood cell (WBC) count and C-reactive protein(CRP), total hospitalization time and costs of surgery were compared between the two groups.Results There was no significant difference between the two groups (P>0.05)in the time taken by blood test indicators to return to normal after operation:WBC [( 4.35±0.87)d vs(5.15±1.04)d]、CRP[(3.35±1.23) d vs (3.64±0.87)d ] and blood AMY [ (4.37±0.89)d vs (4.86±0.79)d] .The total hospitalization time was longer in ERCP group[(12.5±1.5)d vs (8.5±2.0)d](P<0.05). In both groups, the cure rate was 100% and no severe complications or death occurred. During the follow-up, there were two patients whose acute biliary pancreatitis recurred in ERCP group.Conclusions Laparoscopic common bile duct exploration is safe, feasible and of more benefit for patients with obstructive acute biliary pancreatitis,and it can retain the function of the Oddi's sphincter.

Key words： pancreatitis obstruction cholangitis laparoscopy endoscopic retrograde cholangiopancreatography

Received: 07 November 2016

ZTFLH:

R657.51

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	SUN Yanjun
	GONG Renhua
	CAI Jun
	ZHONG Xingguo
	FAN Yulin
	LIU Xueting
	YANG Lliusheng
	and SUN Dengqun

Cite this article:

SUN Yanjun,GONG Renhua,CAI Jun等. Clinical observation of Mini-invasive therapy for obstructive acute biliary pancreatitis[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(5): 490-492.

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2017/V28/I5/490

[1]	中华医学会外科学分会胰腺外科学组. 急性胰腺炎诊治指南(2014)[J]. 中华外科杂志, 2015, 53(1):50-53.
[2]	赵秋登,邬叶锋,程邦君,等. 急性胰腺炎217例病因与临床诊治分析[J].中华肝胆外科杂志,2012,18(8):615-617.
[3]	中华医学会消化病学分会胰腺疾病学组,中华胰腺病杂志编辑委员会,中华消化杂志编辑委员会. 中国急性胰腺炎诊治指南(2013年,上海)[J].临床肝胆病杂志,2013,29(9) :656-660.
[4]	Lerch M M, Aghdassi A A. The role of bile acids in gallstoneinduced pancreatitis[J]. Gastroenterology, 2010, 138(2):429-433.
[5]	李文,范君度,卢焕章,等. 经内镜及外科手术治疗肝胆外胆管结石的治疗效果比较[J].中华消化内镜杂志,2009,16(3):154-156.
[6]	Van Santvoort H C, Besselink M G, de Vries A C, et al. Early endoscopic retrograde cholangiopancreato- graphy in predicted severe acute biliary pancreatitis: a prospective multicenter study[J]. Ann Surg, 2009,250(1):68-75.
[7]	Yokoe M,Takada T, Mayumi T,et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015 [J]. J Hepatobiliary Pancreat Sci, 2015, 22(6):405-432.
[8]	Van Baal M C, Besselink M G, Bakker O J, et al. Timing of cholecystectomy after mild biliary pancreatitis: a systematic review[J]. Ann Surg, 2012, 255(5):860-866.
[9]	Varayu Prachayakul,Pitulak Aswakul. Endoscopic retrograde cholangiopancreatography related perforation: Management and prevention[J].World J Clin Cases,2014,2(10):522-527.
[10]	Sinha R. Early laparoscopic cholecystectomy in acute biliary pancreatitis: the optimal choice[J]. HPB,2008,10:332-335.