Opportunity Of Laparoscopic Cholecystectomy For Non-obstructive Biliary Pancreatitis Caused By Sediment-like Stones

Objective: To compare the effect of emergency operation group,delayed operation group and selective operation group of 72 cases of non-obstructive biliary pancreatitis caused by sediment-like stones by Laparoscopic Cholecystectomy(LC),and to explore the safe operation time of non-obstructive biliary pancreatitis caused by sediment-like stones by LC.Methods: The clinical data of 72 patients undergoing laparoscopic cholecystectomy from December 2012 to December 2018 in our hospital were selected.All patients were diagnosed as non-obstructive biliary pancreatitis before the operation.The diagnostic criteria were as follows:(1)History of previous cholelithiasis or biliary colic.(2)Signs of pancreatitis peritonitis at admission.(3)Blood amylase and lipase elevation.(4)CT was used to identify the pancreatitis and Color Doppler ultrasonography showed that there was no dilatation of common bile duct in the gallbladder.(5)MRCP proved that there was no obvious stones in the common bile duct.(6)Patients without shock and multiple organ dysfunction.A total of seventy-two patients,35 males and 37 females,aged from 22 to 81 years,were treated with anti-inflammatory,acid-suppressing and enzyme-inhibiting treatments and gastrointestinal decompression after admission.Laparoscopic cholecystectomy was performed within 3 days of emergency treatment or delayedwithin 3 to 14 days after conservative treatment.Laparoscopic cholecystectomy or selective conservative treatment were performed within 14 to 30 days after admission.Laparoscopic cholecystectomy.The operation time,intraoperative bleeding volume,intraoperative adhesion of abdominal cavity,conversion to laparotomy rate,abdominal drainage days,preoperative recurrence rate,incidence of complications,total hospitalization days,total hospitalization expenses and other therapeutic effects of the three groups were observed and analyzed.All data were processed and analyzed by SPSS24.0 statistical software,and P value 0f < 0.05 was chosen to indicate the difference.Results: Of 72 patients,68 successfully completed laparoscopic cholecystectomy and 4 cases were converted to open cholecystectomy.Comparing the data of the three groups,it was found that there were differences in operation time,intraoperative bleeding volume,intraoperative abdominal adhesion,conversion rate,abdominal drainage days,preoperative recurrence rate,complication rate,total hospitalization days and total hospitalization costs among the three groups.In terms of intraoperative blood loss and operation time,there were statistically significant differences among the three groups as a whole(P<0.05),among the delayed group,the elective group and the emergency group(P<0.05),while there were no statistically significant differences between the delayed group and the elective group.The emergency group had the largest intraoperative blood loss and the longest operation time.In terms of postoperative drainage volume,there was a statistical difference between the three groups as a whole(P<0.05),and there was a statistical difference between the delay group,the elective group and the emergency group(P<0.05).However,there was no statistical difference between the delay group and the elective group,and the emergency group had the highest postoperative drainage volume.In terms of total hospital days and total hospital expenses,there were significant statistical differences among the three groups(P<0.05).The elective group had the most expenses and the longest length of hospitalization.There were statistically significant differences in the incidence of intraoperative abdominal adhesion among thethree groups(P<0.05),with the highest incidence in the emergency group and the lowest in the delayed group.There were statistically significant differences among the three groups in the interim open rate(P<0.05),among which the emergency group had the highest incidence and the delayed group had the lowest.There were statistically significant differences in the incidence of postoperative complications among the three groups(P<0.05),with the highest incidence in the emergency group and the lowest in the delay group.There was a statistically significant difference in the preoperative recurrence rate among the three groups(P<0.05),with the highest incidence in the elective group and the lowest in the emergency group.CONCLUSION: LC is safe,feasible and economical in the treatment of Non-obstructive pancreatitis caused by sediment-like calculi.Choosing the time of operation to complete laparoscopic cholecystectomy within 3-14 days after non-surgical treatment is safe and feasible.