輕癥急性膽源性胰腺炎腹腔鏡膽囊切除手術(shù)時(shí)機(jī)的探討
本文選題:急性膽源性胰腺炎 + 腹腔鏡; 參考:《新疆醫(yī)科大學(xué)》2017年碩士論文
【摘要】:目的:探討輕癥急性膽源性胰腺炎行腹腔鏡膽囊切除術(shù)的手術(shù)時(shí)機(jī),以評(píng)價(jià)手術(shù)治療的安全性和可行性。方法:回顧性分析2013年1月至2016年8月期間于筆者所在醫(yī)院收治的92例輕型急性膽源性胰腺炎(Ranson評(píng)分3)患者的臨床資料,根據(jù)患者行腹腔鏡膽囊切除術(shù)(LC)前的病程分為早期手術(shù)組(n=47,本次入院的病程2周內(nèi)行LC)與擇期手術(shù)組(n=45,出院后病程6-8周后再次入院行LC)。早期手術(shù)組47例中38例行LC,9例分期行ERCP+EST+ENBD+LC。擇期手術(shù)組45例均行LC,其中10例在急性期行ERCP+EST+ENBD。比較2組患者手術(shù)效果相關(guān)性指標(biāo)及并發(fā)癥發(fā)生情況。結(jié)果:早期手術(shù)組和擇期手術(shù)組患者的術(shù)區(qū)粘連例數(shù)、留置腹腔引流管、術(shù)后住院時(shí)間、術(shù)后并發(fā)癥發(fā)生和術(shù)后胰腺炎復(fù)發(fā)比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),但2組患者的手術(shù)時(shí)間和術(shù)中出血量比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:輕癥急性膽源性胰腺炎患者在本次住院病程2周內(nèi)行腹腔鏡膽囊切除術(shù)是安全、可行的,值得推廣。
[Abstract]:Objective: to evaluate the safety and feasibility of laparoscopic cholecystectomy in patients with mild acute biliary pancreatitis. Methods: the clinical data of 92 patients with mild acute biliary pancreatitis (Ranson score 3) treated in our hospital from January 2013 to August 2016 were analyzed retrospectively. According to the course of laparoscopic cholecystectomy (LC), the patients were divided into early operation group (n = 47) and selective operation group (n = 45). In the early operation group, 38 cases were treated with LCV and 9 cases were treated with ERCP EST ENBD LC. In the elective operation group, 45 cases were treated with LCL, and 10 cases were treated with ERCP EST ENBD in the acute phase. Objective: to compare the correlation index of operation effect and the occurrence of complications between the two groups. Results: the patients in the early operation group and the selective operation group were treated with intraperitoneal drainage tube, the postoperative hospitalization time, the number of adhesions in the operation area, There was no significant difference between postoperative complications and postoperative pancreatitis recurrence (P0.05), but the operative time and intraoperative bleeding volume were significantly different between the two groups (P0.05). Conclusion: laparoscopic cholecystectomy is safe, feasible and worth popularizing in patients with mild acute biliary pancreatitis.
【學(xué)位授予單位】:新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類號(hào)】:R657.4
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 趙玉沛;膽源性胰腺炎診斷標(biāo)準(zhǔn)與處理原則的探討[J];中華肝膽外科雜志;2002年02期
2 張志強(qiáng);葛春林;榮大慶;;膽囊收縮素在膽源性胰腺炎發(fā)病中的作用[J];國(guó)際消化病雜志;2006年06期
3 許守平;孫備;姜洪池;;急性胰腺炎若干研究進(jìn)展[J];中國(guó)實(shí)用外科雜志;2009年07期
4 胡霄;蔣平;倪仲琳;;內(nèi)鏡序貫腹腔鏡膽囊切除術(shù)治療急性膽源性胰腺炎36例觀察[J];現(xiàn)代實(shí)用醫(yī)學(xué);2008年12期
5 柳己海;;急性結(jié)石性膽囊炎腹腔鏡膽囊切除術(shù)手術(shù)時(shí)機(jī)的選擇及中轉(zhuǎn)開腹影響因素分析[J];中國(guó)全科醫(yī)學(xué);2013年03期
6 包文中;孟翔凌;湯大緯;周高潮;王家文;;膽囊結(jié)石合并急性胰腺炎早期和延期腹腔鏡膽囊切除術(shù)臨床療效分析[J];中國(guó)普通外科雜志;2013年09期
7 郭曉東;楊興東;許愛國(guó);李春波;張金燕;;腹腔鏡膽囊切除術(shù)有解剖變異時(shí)避免膽道醫(yī)源性損傷的經(jīng)驗(yàn)與體會(huì)[J];中國(guó)微創(chuàng)外科雜志;2012年04期
8 張誠(chéng);楊玉龍;林美舉;史力軍;張洪威;李婧伊;;十二指腸鏡在復(fù)發(fā)性非結(jié)石性急性胰腺炎中的應(yīng)用[J];肝膽胰外科雜志;2013年06期
9 林健群;洪建文;楊熙;;膽源性胰腺炎240例治療體會(huì)[J];中國(guó)現(xiàn)代普通外科進(jìn)展;2014年08期
10 田青;張雅敏;;腹腔鏡膽囊切除前后急性胰腺炎的臨床特征分析[J];山東醫(yī)藥;2015年04期
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