经内镜逆行胰胆管造影取石术联合腹腔镜治疗急性胆源性胰腺炎患者的效果分析
Effect analysis of endoscopic retrograde cholangiopancreatography combined with laparoscopy on patients with acute biliary pancreatitis
林改革 1黄运德 1季予江 1罗红杰1
作者信息
- 1. 郑州大学附属郑州中心医院肝胆胰微创外科,河南 郑州 450000
- 折叠
摘要
目的:研究经内镜逆行胰胆管造影取石术+腹腔镜治疗急性胆源性胰腺炎患者的效果.方法:回顾性分析 2020年 1 月至 2023 年 6 月期间本院医治的 103 例急性胆源性胰腺炎患者的临床资料,并依据不同手术方法分为观察组(n=53),对照组(n=50),前者行腹腔镜胆囊切除+内镜逆行胰胆管造影取石术,后者行腹腔镜胆囊切除+腹腔镜胆总管探查术.比较两组手术指标、并发症,并于术后 3 d,以酶联免疫法检测血清胃蛋白酶原-Ⅱ(PepsinogenⅡ,PG-Ⅱ)、D-乳酸、胃蛋白酶原-Ⅰ(Pepsinogen I,PG-Ⅰ)、总胆红素(Total bilirubin,TBIL)、谷氨酰转肽酶(Glutamyl transferase,GGT)、谷草转氨酶(Aspartate aminotransferase,AST)、淀粉酶(Amylase,AMS)、晚期蛋白氧化产物(Advanced oxidation protein products,AOPPs)、超氧化物歧化酶(Superoxide dismutase,SOD)水平.结果:观察组住院、进食和临床症状消失时间短于对照组,出血量、医疗费用少于对照组(P＜0.05);与术前相比,各治疗组的AOPPs、PG-Ⅱ、PG-Ⅰ水平均明显上升,D-乳酸、TBIL、GGT、AMS水平均显著降低(P＜0.05),其中观察组更为显著(P＜0.05);两组并发症发生率相比无显著差异(P＞0.05).结论:腹腔镜胆囊切除术+内镜逆行胰胆管造影取石术能促进患者肠胃功能、肝功能恢复,改善生化指标,加快康复进程,安全性较好.
Abstract
Objective:To study the effect of endoscopic retrograde cholangiopancreatography combined with laparoscopy in the treatment of patients with acute biliary pancreatitis.Methods:Retrospective analysis of clinical data of 103 patients with acute gallstone pancreatitis treated in our hospital from January 2020 to June 2023,and divided into observation group(n=53)and control group(n=50)according to different surgical methods.The former underwent laparoscopic cholecystectomy+endoscopic retrograde cholangiopancreatography for stone removal,while the latter underwent laparoscopic cholecystectomy+laparoscopic common bile duct exploration.The surgical indicators and complications of the two groups were compared,and serum levels of pepsinogen II(PG-II),D-lactate,pepsinogen I(PG-I),total bilirubin(TBIL),glutamyl transferase(GGT),aspartate aminotransferase(AST),amylase(AMS),advanced oxidation protein products(AOPPs),and superoxide dismutase(SOD)were detected by enzyme-linked immunosorbent assay at 3 days postoperatively.Results:The observation group had shorter hospitalization,food intake,and clinical symptom disappearance time than the control group,and had less bleeding volume and medical expenses than the control group(P<0.05).Compared with pre-operative levels,the levels of AOPPs,PG-II,and PG-I in each treatment group increased significantly,while the levels of D-lactate,TBIL,GGT,and AMS decreased significantly(P<0.05),with the observation group showing a more significant decrease(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography for stone removal can promote the recovery of gastrointestinal and liver functions,improve biochemical indicators,accelerate the rehabilitation process,and have good safety.
关键词
急性胆源性胰腺炎/腹腔镜/内窥镜/肠胃功能/胰胆管造影Key words
Acute biliary pancreatitis/Laparoscopy/Endoscope/Gastrointestinal function/Cholangiopancreatography引用本文复制引用
出版年
2024
NETL
NSTL
万方数据