Discussion On The Operation Opportunity Of Laparoscopic Cholecystectomy For Gallbladder Stones With Mild Acute Biliary Pancreatitis

Objective:To explore the choice of the operative time of laparoscopic cholecystectomy(LC)for cholecystolithiasis with mild acute biliary pancreatitis(MABP).Methods : Retrospective analysis from January 2014 to December 2017,the fourth hospital affiliated to China Medical University and China Medical University affiliated shengjing hospital treated 166 cases of the clinical data of patients with acute mild biliary pancreatitis,preoperative tests to rule out bravery manager,according to the different operation time is divided into four groups:the onset of 31 patients with surgical treatment of 72 hours for emergency treatment.64 patients who underwent surgical treatment from3 days to 2 weeks after onset were in the early surgery group.From the 2 weeks after the onset of the disease to the time of discharge,39 patients were in the delayed surgery group.32 patients who had a history of mild acute biliary pancreatitis were discharged from hospital after conservative treatment,and were admitted to the hospital for elective surgery after 6 ~ 8 weeks.The operative time,intraoperative blood loss,postoperative drainage time,postoperative recuperation time,postoperative hospitalization time,cumulative hospitalization time,cumulative treatment cost,postoperative complications and postoperative pancreatitis recurrence were analyzed.Results : Intraoperative blood loss(51.61 + 34.58 ml)was higher in the emergency operation group than in the other three groups.Postoperative drainage time(4.61 + 3.68d)in the emergency operation group was longer than that in the other three groups.The cumulative hospitalization time of the emergency operation group and the early operation group was significantly shorter than that of the other two groups.The cumulative treatment costs of the emergency surgery group and the early surgery group were significantly lower than those of the other two groups,and the difference was statistically significant(P < 0.05).There were no statistically significant differences in the mean operative time,postoperative recovery time and postoperative complications between the four groups(P > 0.05).6 months postoperative follow-up,1 case in the emergency operation group,1 case in the early operation group,2 cases in the delayed operation group developed transient pancreatitis 2-8 weeks postoperatively,and no recurrence of pancreatitis in the elective surgery group.Conclusion:For patients without choledocholithiasis MABP,When conditions permit,early surgery significantly shortens the accumulated hospitalization time,reduces the accumulated hospitalization cost,reduces the recurrence rate during the patient’s waiting for surgery,and reduces the patient’s pain and family financial burden.