A Contrastive Analysis About Clinical Effect Of ERCP+EST+ENBD And Traditional Open Abdominal Surgery In Treatment Of Common Bile Duct Stones With Acute Biliary Pancreatitis

Objective To retrospectively analyzed the clinical effect of ERCP+EST+ENBD and common bile duct exploration combined with endobiliary drainage in the treatment of acute biliary pancreatitis.Methods The analysis was performed on the clinical date of 86 patients with acute pancreatitis with common bile duct stones which was admitted to the first affiliated hospital of Anhui medical university emergency surgical department from January 2012 to October2015.Divided the patients into 2 groups according to the different treatment method.56 patients were received ERCP+EST+ENBD(ERCP group)and 30 patients underwent common bile duct exploration combined with endobiliary drainage(CBDE group).Changes in white blood cell(WBC)count,total bilirubin(TBil),alanine aminotransferase(ALT),and C-reactive protein(CRP)after operation,The blood amylase(AMYL),abdominal symptoms,intestinal recovery time,total time in hospital,the hospital total cost,stone clearance rate and postoperative complications were under analyzed.Results1.The general data of 86 cases of patients which were under analyzed(56 cases for ERCP group and 30 cases for CBDE group),and the two groups of patients with preoperative general data were comparable(p > 0.05);2.Contrast analysis of lab index of two groups of patients before and after operation : WBC,CRP levels,AMYL,TBIL,ALT of the two groups of patients before the operation after contrast analysis shows that the two sets of data had no statistical difference(p > 0.05).The above index of the two groups of patients were lower in the two groups than before the operation.In the first day of operation,only AMYL,TBIL,and ALT were compared to the surgery,and the difference was statistically significant(p < 0.05).In the third and seventh day after the operation,the ERCP group compared with CBDE group,the index of each laboratory was significantly lower(p < 0.05);There was no statistical difference(p > 0.05)when the two groups of data were compared in the other days.3.The comparison of two groups of patients after surgery and hospitalization: ERCP group of patients with postoperative abdominal symptoms time and recovery time of gastrointestinal tract compared with control group,with statistical difference(p < 0.05).The CBDE group(the control group)compared with the ERCP group,the total cost of the hospital(yuan)and the total length of hospital stay(day)were higher(P < 0.05),there are statistical differences.Both groups had no post-operative complications.4.Two groups of patients were followed up for 6 months after hospital discharge,postoperative abdominal ultrasound or MRCP or choledochoscope probe shows that: ERCP group of patients with no obvious postoperative calculi residual,and the CBDE group have had a 6.06%incidence with calculi residual(2/30).Conclusions ERCP+EST+ENBD has a good postoperative recovery,reduce the length of hospital stay,the cost of hospitalization and the patient's economic burden for common bile duct stones with acute pancreatitis,it.