Assessment of early results of surgical treatment of acute biliary pancreatitis at Viet Duc University Hospital

Hong Quan Dinh
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Abstract

treatment requires radical treatment. ERCP, percutaneous lithotripsy, and surgery are effective treatments. The purpose of this paper is to evaluate the early results of surgical treatment of acute biliary pancreatitis. Patients and methods: A retrospective review of all patients diagnosed with acute pancreatitis due to gallstones was surgically treated at the Department of Hepatobiliary Surgery of Viet Duc University Hospital from January 2019 to December 2021. Results: The study group has 49 patients (26 female, 23 male). The mean age at surgery was 56.8 (28-87 years). CT scan identified 100% of pancreatic lesions and gallstones before surgery, of which common bile duct stones accounted for 20.4%, the rest were common bile duct stones combined with gallstones and stones in the liver. One patient was diagnosed with septic shock caused by cholangitis had to be resuscitated before surgery. The surgical intervention on biliary tract was cholecystectomy, stone removal, endoscopic lithotripsy, T tube drainage, combined cholecystectomy and left lobectomy. Open surgery was performed on 35 patients, accounting for 71.4%, and laparoscopic surgery accounted for 28.6%. The intervention on the pancreas was on 8 patients, mainly removing the necrotic pancreatic tissue, draining the lesser sac. Most patients had surgery in the first 2 days, as early as 22 hours, as late as 8 days. There were two patients complicated the surgical site infection, two patients with biliary leak, one patient with acute pancreatitis, all were treated medically. The mean hospital stay was 5.1 days. Laparoscopic surgery gave good results, accounting for 92.9%, there were no severe cases of recurrence or death. 49 patients were followed up 30 days after surgery with a good result (85.7%), no mortality was observed. Conclusion: Surgical treatment for acute biliary pancreatitis is safe which assesses pancreatic damage, gives good postoperative results. Keywords: Acute pancreatitis, gallstones, surgery
越南大学医院急性胆源性胰腺炎手术治疗早期效果评价
治疗需要根治性治疗。ERCP、经皮碎石和手术是有效的治疗方法。本文的目的是评价手术治疗急性胆源性胰腺炎的早期效果。患者和方法:回顾性分析2019年1月至2021年12月在越南大学医院肝胆外科接受手术治疗的所有诊断为胆结石性急性胰腺炎的患者。结果:研究组患者49例,其中女性26例,男性23例。手术时平均年龄为56.8岁(28-87岁)。术前CT扫描胰腺病变及胆结石检出率100%,其中总胆管结石占20.4%,其余为总胆管结石合并胆结石及肝内结石。一名患者被诊断为胆管炎引起的感染性休克,在手术前必须进行复苏。胆道手术干预为胆囊切除术、取石术、内镜下碎石术、T管引流术、胆囊联合左肺叶切除术。开放手术35例,占71.4%,腹腔镜手术占28.6%。胰腺干预8例,主要是切除坏死胰腺组织,引流小囊。多数患者手术时间在前2天,最早22小时,最晚8天。2例合并手术部位感染,2例合并胆漏,1例合并急性胰腺炎,均接受了内科治疗。平均住院时间为5.1天。腹腔镜手术治疗效果良好,占92.9%,无严重复发及死亡病例。49例患者术后30 d随访,效果良好(85.7%),无死亡。结论:手术治疗急性胆源性胰腺炎是安全的,可评估胰腺损伤,术后效果良好。关键词:急性胰腺炎,胆结石,手术
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