探讨双镜联合手术治疗重症急性胰腺炎并发胰腺假性囊肿的安全性及细胞炎性因子的改善情况。

回顾性分析2015年4月至2017年3月86例重症急性胰腺炎并发胰腺假性囊肿患者资料，根据治疗方案的不同分为开腹组(n＝40)与双镜组(n＝46，采用十二指肠镜与腹腔镜的联合治疗)。采用SPSS20.0统计学软件分析，两组患者并发症发生率采用χ²检验比较；术中术后各项指标、血清炎性因子水平等计量资料以(±s)表示，采用独立t检验，P<0.05差异有统计学意义。

双镜组患者的手术时间、术中出血量、住院时间、腹痛缓解时间、排气时间、体温恢复时间等均明显优于开腹组患者(P<0.05)；双镜组术后并发症的发生率7.5%明显低于开腹组患者26.1%(P<0.05)；术后双镜组患者IL－18、IL－6与TNF－α水平明显低于开腹组患者(P<0.05)。

采用双镜联合手术方案治疗重症急性胰腺炎合并胰腺假性囊肿，手术效果更好，术后并发症较少，可有效改善患者的临床症状，值得临床进一步应用推广。

To investigate the safety of Laparoscopy combined with duodenoscopy for the treatment of pancreatic pseudocysts complicated with severe acute pancreatitis and the improvement of inflammatory cytokines.

A retrospective analysis of 86 patients with pancreatic pseudocysts complicated with severe acute pancreatitis from April 2015 to March 2017 was studied. According to the treatment plan, patients were divided into Laparoscopy combined with duodenoscopy group (n=46) and laparotomy group (n=40) In the Laparoscopy combined with duodenoscopy group, endoscopic and laparoscopic treatments were used. In the open group, traditional open surgery was used. SPSS20.0 statistical software was used to analyze. The incidence of complications between the two groups were compared using the χ² test. The measurement data of each index and serum inflammatory factor level during the operation were expressed as (±s), and compared with Independent t test, P<0.05meant the difference was statistically significant.

The operation time, intraoperative blood loss, length of hospital stay and other surgical indicators in the Laparoscopy combined with duodenoscopy group were significantly lower than those in the open group (P<0.05); abdominal pain relief time, exhaust time, and body temperature recovery time in the Laparoscopy combined with duodenoscopygroup were significantly better than those in the open group (P<0.05); the incidence of postoperative complications in the Laparoscopy combined with duodenoscopy group was significantly lower than that in the open group (7.5% vs. 26.1%) (P<0.05); The levels of IL-18, IL-6 and TNF-α in the patients of the Laparoscopy combined with duodenoscopy group were significantly lower than those in the open group (P<0.05).

The use of Laparoscopy combined with duodenoscopy to treat pancreatic pseudocysts complicated with severe acute pancreatitis has better surgical outcomes and fewer postoperative complications, which can effectively improve the patient’s clinical symptoms and is worthy of further clinical application.