Minimally invasive surgical treatment with per-pancreat region for sever acute pancreatitis / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical effect of the minimally invasive surgical treatment with per-pancreat region for sever acute pancreatitis (SAP).</p><p><b>METHODS</b>Fify-four cases of SAP were divided into two groups, patients of group A (n = 28) were given minimally invasive surgical treatments (step 1: under local anesthesia, patients were put the home-made double cannula in the abdominal around the region of pancreas.step 2:patients with biliary stone were performed by laparoscopical operations). Patients of group B (n = 26) were treatment by open operations including biliary decompression, gastrostomy, jejunostomy, removing necrotic pancreatic organizations and puting the double cannula around the region of pancreas. Through double cannula around the pancreas area, all patient's cavity were persistently douched using 0.5% 5-FU saline solution.</p><p><b>RESULTS</b>Washed after one week, two groups patient's drainage fluid amylase concentration were decreased significantly (t = 2.68, P = 0.013; t = 2.41, P = 0.028), patient's white cell count, body temperature, heart rate of Groups A were also decreased significantly (t = 2.32, P = 0.035; t = 2.39, P = 0.021; t = 2.38, P = 0.023). Compared with group B, the mortality, the incidence of complications, hospitalization time and total cost of treatment of group A patients were significantly lower than that of group B (chi(2) = 8.62, P = 0.001; chi(2) = 6.35, P = 0.014; t = 2.22, P = 0.034; t = 2.67, P = 0.010), but the cure rate was significantly higher than that of group B (chi(2) = 3.89, P = 0.045).</p><p><b>CONCLUSIONS</b>Minimally invasive surgical treatment of per-pancreatic region for SAP can not only remove the causes, but also fully drainage and timely block the pathological vicious cycle of SAP. What is more, it is simple, minimally invasive and have few complications and significant effect.</p>