Operation timing of laparoscopic cholecystectomy in mild acute billiary pancreatitis
10.3760/cma.j.issn.1674-1935.2019.04.007
- VernacularTitle:轻症急性胆源性胰腺炎行腹腔镜胆囊切除术的手术时机
- Author:
Lan JIANG
1
;
Chunfang XU
Author Information
1. 苏州大学附属第一医院消化内科
- Keywords:
Pancreatitis;
Cholelithiasis;
Cholecystectomy,laparoscopic;
Optimal timing
- From:
Chinese Journal of Pancreatology
2019;19(4):270-274
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the operation timing of laparoscopic cholecystectomy ( LC ) for patients with first onset of mild acute biliary pancreatitis ( ABP) . Methods From January 2012 to December 2017, a total of 905 ABP patients who admitted to the First Affiliated Hospital of Soochow University were retrospectively assessed. Among them, 165 ABP patients underwent LC. According to the different operation time after hospitalization, the patients were divided into 5 groups: within 2 weeks surgery group, 2-4 weeks surgery group, 4 -8 weeks surgery group, 8 -24 weeks surgery group and 24 weeks later surgery group. Surgery difficulty, postoperative recovery, total hospitalization time and recurrence of acute biliopancreatic disease before surgery were compared between the 5 groups. Results LC was successfully completed in all 165 patients. There was no statistically significant difference on the surgical difficulty and postoperative recovery among the 5 groups (P>0. 05). The total hospitalization time of within 2 weeks surgery group and 2-4 weeks surgery group was significantly shortened compared with that in 4-8 weeks surgery group, 8-24 weeks surgery group and 24 weeks later surgery group [14.5(8.0-21.0)d, 14.0(7.0-23.0)d]vs [17.0 (6.0-42.0)d, 20.0(9.0-46.0)d, 21.5(7.0-42.0)d], and the difference was statistically significant (P<0. 05). Moreover, the recurrence rate of acute biliopancreatic disease was 0 in within 2 weeks surgery group while waiting for surgery, which was lower than those of other four groups [6. 1％(2/33),38. 5％(15/39),61.5％(24/39),77.3％(17/22)], and the difference was statistically significant (P<0.05). Conclusions For ABP patients with first onset, LC was safe and feasible within 2 weeks after conservative treatment, which can significantly shorten the total hospitalization time and reduce the recurrence rate of acute biliopancreatic diseases during the waiting period.
