The safety and timing of surgery of laparoscopic surgery for treatment of acute pancreatitis caused by gallstones

doi:10.3877/cma.j.issn.1674-3946.2019.06.020.

Abstract

Abstract:

Objective

To investigate the safety and timing of laparoscopic surgery for the treatment of acute pancreatitis caused by gallstones.

Methods

The clinical data of 94 patients with acute pancreatitis caused by gallstones were retrospectively selected. The patients were divided into early operation group (within 48 hours) and delayed operation group (after 48 hours) according to the time of surgery, 52 and 42 cases respectively. Data analysis was performed by statistical software SPSS22.0. Surgery-related indicators were expressed by (±s) and compared with independently t test. The rate of using analgesics, the rate of complete resection, the rate of conversion to laparotomy and the incidence of complications werecompared by χ² test, P<0.05 indicated the difference was statistically significant.

Results

The operation time, intraoperative blood loss, postoperative venting time, hospitalization time and the cost of hospitalization of the early operation group were less than those of the delayed operation group (P<0.05). The analgesic drug use rate and conversion rate were lower in the early operation group than those in the delayed operation group (P<0.05), and the complete resection rate was higher in the early operation group than that in the delayed operation group (P<0.05). After surgery, the levels of IL-6 and CRP in the two groups were higher than those before surgery and IL-10 was lower than that before surgery (P<0.05), and the IL-6 and CRP levels in the early group were lower than those in the delayed group, and IL-10 was higher than that in the delayed group (all P<0.05). The incidence of complications in the early group was 3.8%, which was significantly lower than that in the delayed group (19.0%) (P<0.05).

Conclusion

Early laparoscopic surgery for acute pancreatitis caused by gallstones can reduce the postoperative analgesic drug use rate, conversion rate and complication rate, the safety is higher, the body’s stress response was less after surgery, and the clinical effect is better than delayed surgery. It is worthy of popularization and application.

Key words: Pancreatitis, acute necrotizing, Cholecystolithiasis, Laparoscopes, Safety

Yingchun Wang, Zhongqi Mao, Xiangxiu Wu, Xin Chen, Xining Liu. The safety and timing of surgery of laparoscopic surgery for treatment of acute pancreatitis caused by gallstones[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 606-609.

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References 24

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组别	例数	年龄(岁)	体重(kg)	性别	胰腺炎分级
组别	例数	年龄(岁)	体重(kg)	男/女	轻度/重度
早期组	52	43.6±5.7	64.4±8.5	33/19	41/11
延期组	42	45.4±4.3	61.6±9.2	28/14	32/10
t/χ²值	?	－1.6934	1.5304	0.7462	0.0944
P值	?	>0.05	>0.05	>0.05	>0.05

组别	例数	年龄(岁)	体重(kg)	性别	胰腺炎分级
组别	例数	年龄(岁)	体重(kg)	男/女	轻度/重度
早期组	52	43.6±5.7	64.4±8.5	33/19	41/11
延期组	42	45.4±4.3	61.6±9.2	28/14	32/10
t/χ²值	?	－1.6934	1.5304	0.7462	0.0944
P值	?	>0.05	>0.05	>0.05	>0.05

组别	手术时间(min)	术中出血量(ml)	术后排气时间(d)	住院时间(d)	住院费用(万元)
早期组	59.6±8.2	11.4±1.5	1.8±0.6	2.8±0.6	0.9±0.5
延期组	68.2±4.8	20.3±2.6	2.7±0.8	4.6±0.7	1.7±0.4
t值	－6.0120	－20.7851	－6.2306	－13.4209	－7.891
P值	<0.05	<0.05	<0.05	<0.05	<0.05

组别	手术时间(min)	术中出血量(ml)	术后排气时间(d)	住院时间(d)	住院费用(万元)
早期组	59.6±8.2	11.4±1.5	1.8±0.6	2.8±0.6	0.9±0.5
延期组	68.2±4.8	20.3±2.6	2.7±0.8	4.6±0.7	1.7±0.4
t值	－6.0120	－20.7851	－6.2306	－13.4209	－7.891
P值	<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	镇痛药物使用率	完全切除率	中转开腹率
早期组	52	2(3.8)	51(98.1)	1(1.9)
延期组	42	8(19.0)	29(69.1)	7(16.7)
t值	?	5.6477	15.4467	6.4863
P值	?	<0.05	<0.05	<0.05

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