腹腔镜、胆道镜、十二指肠镜联合治疗老年性轻型胆源性胰腺炎临床研究

摘要/Abstract

摘要：

摘要：目的评价腹腔镜、胆道镜、十二指肠镜联合（即三镜联合）治疗老年轻型胆源性胰腺炎与传统开腹胆囊切除+胆管取石手术的安全性和有效性。方法回顾性分析宝鸡市人民医院肝胆外科2013年1月至2020年12月收治的80例老年轻型胆源性胰腺炎患者，患者分别接受开腹手术或三镜联合手术治疗。根据手术方式不同分为对照组（传统开腹手术）和观察组（三镜联合治疗）各40例。比较两组患者的术后并发症发生率、术中出血量、结石清除成功率、手术成功率、胰腺炎重型化比例、胃肠道功能恢复时间、血淀粉酶恢复时间、住院时间和住院费用。结果观察组术后并发症发生率及术中出血量低于对照组。但两组间结石清除率、胰腺炎重型化比例、手术成功率差异无显著性。观察组的住院时间和胃肠道功能恢复时间短于对照组，此外与先经内镜逆行胰胆管造影治疗，1~2周后再行腹腔镜胆囊切除术+腹腔镜胆总管探查术的序惯性治疗相比，开腹手术血淀粉酶恢复正常时间明显延长。两组的住院费用比较差异无显著性。结论腹腔镜、胆道镜、十二指肠镜联合治疗老年轻型胆源性胰腺炎是一种更安全有效的方法，手术并发症少、住院时间短，但需二期手术。

关键词: 胆囊, 胆总管结石, 腹腔镜, 胆道镜, 十二指肠镜, 老年性胆源性胰腺炎

Abstract:

Abstract: Objective To evaluate the safety and effectiveness of combination of laparoscopy, choledochoscope and duodenoscope combination of three glasses in the treatment of senile mild biliary pancreatitis and traditional open cholecystectomy plus choledocholithotomy. Methods 80 patients with mild biliary pancreatitis from January 2013 to December 2020 in the Hepatobiliary Surgery Department of Baoji People's Hospital were retrospectively analyzed. The patients received laparotomy or threemirror combined surgery respectively. According to different surgical methods, they were divided into control group (traditional laparotomy) and observation group (combined therapy of three mirrors) with 40 cases each. Two groups’ postoperative complications, intraoperative blood loss, stone removal success rate, surgical success rate, severe pancreatitis rate, gastrointestinal function recovery time, blood amylase recovery time, hospitalization time and hospitalization expenses were compared. Results The incidence rate of postoperative complications and intraoperative blood loss of observation group were lower than that of control group. However, there was no significant difference between the two groups in stone clearance rate, severe pancreatitis rate and operation success rate. The hospitalization time and gastrointestinal function recovery time of the observation group are lower than those of the control group. In addition, compared with endoscopic retrograde cholangiopancreatography treatment and laparoscopic cholecystectomy + laparoscopic common bile duct exploration sequential inertia treatment after 1~2 weeks, the recovery time of blood amylase in the open surgery is significantly prolonged. However, there was no significant difference in hospitalization expenses between the two groups. Conclusion Combined treatment of three glasses for elderly senile biliary pancreatitis is a safer and more effective method. It has fewer surgical complications, shorter hospital stay, but requires secondary surgery.

Key words: Gallbladder, Choledocholithiasis, Laparoscopy, Choledochoscope, Duodenscopy, Senile biliary pancreatitis

焦振东, 郭智华, 刘益民. 腹腔镜、胆道镜、十二指肠镜联合治疗老年性轻型胆源性胰腺炎临床研究 [J]. 临床普外科电子杂志, 2021, 9(3): 8-.

JIAO Zhendong, GUO Zhihua, LIU Yimin. Clinical study on combined treatment of laparoscopy, choledochoscope and duodenoscopy for senile mild biliary pancreatitis [J]. Journal of General Surgery for Clinicians, 2021, 9(3): 8-.

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腹腔镜、胆道镜、十二指肠镜联合治疗老年性轻型胆源性胰腺炎临床研究

Clinical study on combined treatment of laparoscopy, choledochoscope and duodenoscopy for senile mild biliary pancreatitis

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