CAJ | 학술논문

目的探讨胆囊结石合并轻中度胰腺炎患者实施早期腹腔镜胆囊切除术(LC)的可行性及手术时机.方法将26例确诊后经保守治疗病情平稳、发病48 h内行LC术轻中度胆囊结石伴胰腺炎的患者列为早期LC组,与58例延期手术组的临床资料作对照研究.结果所有LC手术成功.早期手术组术后第1、3、5、7天的丙氨酸转氨酶+天冬氨酸转氨酶、血尿淀粉酶、碱性磷酸酶与延期手术组入院治疗第1、3、5、7天比较,差异无统计学意义(P＞0.05).早期手术组住院日明显缩短(P＜0.05).两组手术时间、术中出血量、术后并发症发生率、术后胰腺炎复发率差异均无统计学意义(P＞0.05).结论明确排除胆总管结石后,胆囊结石合并轻中度胰腺炎在发病48 h内行早期LC是安全可行的.
목적 탐토담낭결석합병경중도이선염환자실시조기복강경담낭절제술(LC)적가행성급수술시궤.방법 장26례학진후경보수치료병정평은、발병48 h내행LC술경중도담낭결석반이선염적환자렬위조기LC조,여58례연기수술조적림상자료작대조연구.결과 소유LC수술성공.조기수술조술후제1、3、5、7천적병안산전안매+천동안산전안매、혈뇨정분매、감성린산매여연기수술조입원치료제1、3、5、7천비교,차이무통계학의의(P＞0.05).조기수술조주원일명현축단(P＜0.05).량조수술시간、술중출혈량、술후병발증발생솔、술후이선염복발솔차이균무통계학의의(P＞0.05).결론 명학배제담총관결석후,담낭결석합병경중도이선염재발병48 h내행조기LC시안전가행적.
Objective To study the feasibility and timing of early laparoscopic cholecystectomy (LC) for the patients with mild-to-moderate acute pancreatitis with gallbladder stone.Methods 26 patients with mild-to-moderate acute pancreatitis with gallbladder stone underwent early laparoscopic cholecystectomy.The patients were initially treated with conservative treatment.When the diagnosis was confirmed and the patients were stable,LC was carried out within 48 hours of hospitalization.The results were compared with a delayed group of patients who received delayed LC for acute pancreatitis.Results All the LC operations were successfully carried out.There were no significant differences between the two groups in alkaline phosphatase,alanine aminotransferase,aspartate aminotransferase,blood amylase and urine armylase on postoperative day 1,3,5,7.Patients who received early laparoscopic cholecystectomy had a shorter hospital stay.There were no significant differences between the two groups in the operation time,intraoperative blood loss,postoperative complication rates and recurrence of acute pancreatifis.Conclusion After CBD stones have been ruled out,it is safe and feasible to carry out early laparoscopic cholecystectomy within 48 hours of hospital admission for patients with mild-to-moderate acute pancreatitis with gallbladder stone.