AbstractObjective 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.
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.
2017, Vol. 28 
