关键词: 胆囊结石, 急性胆源性胰腺炎, 腹腔镜胆囊切除术, 手术时机, 疗效, 肠道功能

Abstract: Objective To explore the effect of early and delayed laparoscopic cholecystectomy on cholecystolithiasis and the influence of postoperative intestinal function. Methods The data of 84 cases of cholecystitis due to cholecystolithiasis treated in our department from January 2018 to January 2020 were retrospectively analyzed.According to the time of laparoscopic cholecystectomy from the onset of the disease to the onset of the disease,the patients were divided into the early group(within 48h) in 44 cases and the delayed group(more than 48h) in 40 cases.The indicators related to surgery,complications,and the rate of conversion to open surgery were compared between the two groups,and the differences of postoperative intestinal function indicators were compared between the two groups.Results The differences of operation time [(64.51±5.27)min vs(85.34±7.64)min],intraoperative bleeding volume [(41.26±5.41)ml vs(86.54±9.28)ml],hospital stay [(3.1±0.7)d vs(4.6 ±0.9)d] between the early group and the delayed group were statistically significant(P<0.05).The conversion rate was 2.27% in the early group and 17.50% in the delayed group.The difference was statistically significant between the two groups(P<0.05).The incidence of postoperative complications was 4.55% in the early group and 12.50% in the delayed group.There was no significant difference between the two groups(P>0.05).The differences of postoperative recovery time of borborygmus [(15.74±4.21)h vs(24.27±6.35)h],postoperative first exhaust time [(1.25±0.43)d vs(2.47±0.64)d],and postoperative first defecation time [(2.43±0.76)d vs(3.79±0.81)d] between the early group and the delayed group were statistically significant(P<0.05).Conclusions Early laparoscopic cholecystectomy for acute biliary pancreatitis caused by cholecystolithiasis is safe,and the intestinal function recovers quickly after operation.Its clinical effect is better than that of delayed laparoscopic cholecystectomy.

Key words: gallstone, acute biliary pancreatitis, laparoscopic cholecystectomy;operation time;efficacy;intestinal function