中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2010年
3期
170-172,175
,共4页
李建水%赵国刚%彭祥玉%任亦星%武国%李敬东
李建水%趙國剛%彭祥玉%任亦星%武國%李敬東
리건수%조국강%팽상옥%임역성%무국%리경동
急性胰腺炎%腹腔镜%胆道镜%胆总管结石
急性胰腺炎%腹腔鏡%膽道鏡%膽總管結石
급성이선염%복강경%담도경%담총관결석
Acute pancreatitis%Laparoscopy%Choledochoscopy%Common bile duct gall stones
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.
目的 探討對急性胰腺炎(AP)閤併膽總管結石早期行腹腔鏡聯閤膽道鏡治療方式的可行性.方法 分析我院2007年1月至2009年11月收治的102例AP閤併膽總管結石患者.研究組43例,均早期(入院72 h內)行腹腔鏡下膽囊切除、膽總管切開取石T管引流術加術中膽道鏡取石術;其中13例還行胰腺被膜切開加腹腔灌洗引流.對照組59例,先均行保守治療.其中46例在胰腺炎明顯好轉後,纔行腔鏡手術;另9例齣現重癥膽管炎、4例胰週感染時,行急診開腹手術.結果 兩組比較,在胃腸道功能恢複時間、澱粉酶恢複時間、住院時間及住院費用比較差異均有統計學意義 (P<0.05).結論 對AP閤併膽總管結石患者早期實施腹腔鏡聯閤膽道鏡榦預是一種創傷小、恢複快、安全有效的方法.
목적 탐토대급성이선염(AP)합병담총관결석조기행복강경연합담도경치료방식적가행성.방법 분석아원2007년1월지2009년11월수치적102례AP합병담총관결석환자.연구조43례,균조기(입원72 h내)행복강경하담낭절제、담총관절개취석T관인류술가술중담도경취석술;기중13례환행이선피막절개가복강관세인류.대조조59례,선균행보수치료.기중46례재이선염명현호전후,재행강경수술;령9례출현중증담관염、4례이주감염시,행급진개복수술.결과 량조비교,재위장도공능회복시간、정분매회복시간、주원시간급주원비용비교차이균유통계학의의 (P<0.05).결론 대AP합병담총관결석환자조기실시복강경연합담도경간예시일충창상소、회복쾌、안전유효적방법.
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.
