Comparison of two modalities of minimally invasive surgery in treatment of acute biliary pancreatitis / 中华全科医师杂志

ABSTRACT

Objective To compare the therapeutic efficacy of laparoscopic common bile duct exploration (LCBDE) plus laparoscopic cholecystectomy (LC),and endoscopic retrograde cholangiopancretography (ERCP) plus endoscopic sphinetemtomy (EST) plus laparoscopic cholecystectomy (LC) in treatment of acute biliary pancreatitis.Method One hundred and six patients with acute biliary pancreatitis and biliary obstruction underwent minimally invasive surgery between January 2012 and February 2016 in our hospital,including 54 cases received LCBDE + LC (LCBDE group) and 52 cases received ERCP + EST + LC (ERCP group).The operation time,intraoperative blood loss,length of hospital stay,medical expenses and postoperative complications were compared between two groups.Results The operating time in LCBDE group was longer than that in ERCP group [(110.2 ± 11.2) min vs.(100.8 ±22.8) min,x2 =-2.11,P ＜ 0.05],the length of hospital stay was shorter [(10.3 ± 3.8) d vs.(12.6 ±3.4) d,x2 =2.32,P ＜ 0.05],the medical expense was less [(31 245.3 ± 1 237.2) Yuan vs.(42 342.2 ±1 354.3)Yuan,x2 =2.82,P ＜ 0.01].There were no significant differences in intraoperative blood loss [(40.2 ± 10.3) ml vs.(39.3 ± 10.4) ml,x2 =0.88,P ＞ 0.05],the rate of postoperative analgesic use [11.11％ (6/54) vs.13.46％ (7/52),x2 =0.102,P ＞0.05] and the incidence of postoperativecomplications [9.26％ (5/54) vs.11.54％ (6/52),x2 =0.080,P ＞0.05] between two groups.Conclusion laparoscopic common bile duct exploration plus laparoscopic cholecystectomy has advantages of shorter hospital stay and lower medical expenses in treatment of acute biliary pancreatitis combined with biliary infection.