Clinical Efficacy Analysis Of Different Treatment Methods In The Early Stage Of Severe Acute Biliary Pancreatitis

Objective:Severe acute biliary pancreatitis(SABP)has a high mortality rate and poor prognosis,and early clinical intervention can minimize its damage to human life and health.Therefore,this study will conduct a retrospective analysis of clinical data from patients with SABP to explore endoscopic retrograde cholangiopancreatography(ERCP),percutaneous transhepatic gallbladder drainage,PTGBD)and conservative treatment in the early clinical stage(admission < 48 h,admission 48～72h)for SABP patients,and the clinical value of PTGBD and ERCP and the timing of their respective treatment methods were analyzed.Methods:A retrospective analysis was done for the clinical data of 59 patients with SABP admitted to Liaoning Province People’s Hospital from January 2016 to September 2022.According to the different treatment methods of patients in the early stage of admission(less than 72h),the patients were divided into three groups:conservative group(n=23),PTGBD group(n=15),ERCP group(n=21),and according to the different time of surgical operation after admission,ERCP group and PTGBD group were divided into <48h and 48～72h groups.The differences between laboratory indicators(WBC,AMS,TBIL,ALT values and return to normal time)and nonlaboratory indicators(oral feeding time,hospital stay,complication rate and mortality)between the three groups,PTGBD group and ERCP group(admission <48h and48～72h).Results:(1)After 3 days of treatment,the WBC,AMS,TBIL and ALT values decreased more significantly in the ERCP group and the PTGBD group(P<0.05)compared with the conservative group;Four laboratory indicators were reduced in the ERCP group(P<0.05)in the four laboratory indicators,oral feeding time,and length of hospital stay(P0.05),;P and the TGBD group had a decrease in the time to return to normal AMS,TBIL and ALT values,and reduced the oral feeding time(P<0.05).In addition,compared with the PTGBD group,the ERCP group had a shorter TBIL return time and shorter hospital stay(P<0.05).There was no significant difference in morbidity and mortality between the three groups(P>0.05).(2)After 3 days of treatment,there was no difference in laboratory and non-laboratory indexes between the two time groups(48h and 48～72h < admission)(P>0.05).(3)After 3 days of treatment,there was no difference between laboratory and non-laboratory indexes between the two time groups(48h < admission,48～72h)of ERCP operation(P>0.05).Conclusion:(1)PTGBD can be used as the preferred method for early intervention of SABP or as an alternative after ERCP failure.(2)The early operating time window can be relaxed from 48 hours to 72 hours of admission,especially for ERCP,which can be more fully prepared before general anesthesia.