Clinical effect of laparoscopic common bile duct exploration combined with endobiliary drainage in treatment of acute biliary pancreatitis
10.3969/j.issn.1001-5256.2015.05.013
- VernacularTitle:腹腔镜胆总管探查内置管引流术治疗急性胆源性胰腺炎的临床观察
- Author:
Jinchun SUN
- Publication Type:Journal Article
- Keywords:
pancreatitis;
cholestasis;
cholangitis;
laparoscopy;
drainage
- From:
Journal of Clinical Hepatology
2015;31(5):687-690
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical effect of laparoscopic common bile duct exploration combined with endobiliary drainage in the treatment of acute biliary pancreatitis.Methods A retrospective analysis was performed on the clinical data of 90 patients with acute biliary pancreatitis admitted to our hospital from January 2012 to May 2014.Among them,42 patients received laparoscopic common bile duct ex-ploration combined with endobiliary drainage (laparoscopic group),and 48 patients underwent endoscopic retrograde cholangiopancreatogra-phy (ERCP)combined with endoscopic sphincterotomy (ERCP group).The operation situation,changes in white blood cell (WBC) count,total bilirubin (TBil),alanine aminotransferase (ALT),and C -reactive protein (CRP)after operation,and follow -up results were analyzed.Comparison of continuous data between the two groups was made by t test,while comparison of categorical data was made by chi -square test.Results There were no significant differences in operation time,intraoperative blood loss,hospitalization expenses,and the incidence of complications between the two groups (all P >0.05).On the 1st,3rd,and 7th days after operation,the two groups had re-duced WBC count and serum levels of TBil,ALT,and CRP,but the reduction was significant only on the 3rd and 7th days in both groups (all P <0.05).On the 3rd day,the laparoscopic group had significantly lower WBC count and CRP level than the ERCP group (both P <0.05),but none of all the indices showed significant differences between the two groups at other time points (all P >0.05).In the 6 -month follow -up,the incidence of regurgitation cholangitis in the ERCP group was 6.25% (3 /48),but no complications were found in the laparoscopic group (χ2 =2.716,P =0.099).Conclusion Laparoscopic common bile duct exploration combined with endobiliary drainage is safe and feasible for acute biliary pancreatitis,and it can retain the function of the Oddi′s sphincter.
