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Chinese Journal of Laparoscopic Surgery(Electronic Edition) ›› 2017, Vol. 10 ›› Issue (03): 170-174. doi: 10.3877/cma.j.issn.1674-6899.2017.03.012

Special Issue:

• Original Article • Previous Articles     Next Articles

Comparative study of laparoscopic and open surgery for complicated pancreatic duct stones

Dongjun An 1 , ( ), Lin An 2, Cheng Zhang 1, Li Han 1, Jinge Feng 1   

  1. 1. Department of Hepatobiliary Surgery, the Center Hospital of Xianyang City, Xianyang 712000, China
    2. School of Statistics , Xi′an University of Finance and Economics, Xi′an 710100, China
  • Received:2017-04-07 Online:2017-06-30 Published:2017-06-30
  • Contact: Dongjun An
  • About author:
    Corresponding author: An Dongjun, Email:

Abstract:

Objective

To investigate the effect of laparoscopic surgery and open surgery in the treatment of complicated pancreatic duct stones.

Methods

The clinical data of 35 cases of complicated pancreatic duct stones were analyzed retrospectively. 16 cases were treated by laparoscopy ( group A ) and 19 cases were open surgery (group B ) from Mar. 2012 to May 2016 in the Center Hospital of Xianyang City. Before and after surgery the insulin resistance index(IR), level of serum C-reactive protein, the amount of bleeding during operation and the time of operation, the number of analgesics used after the operation, the exhaust time, the extraction time of the abdominal cavity drainage tube, the postoperative hospital stay, total hospital expenses and postoperative complications were detected. The pain grade was evaluated according to WHO pain classification method before and after operation.

Results

Both groups were cured and discharged without perioperative death. The amount of bleeding and operation time in group A were better than that in group B (t=5.487, 8.365, P<0.05), the difference was statistically significant.The changes of insulin resistance index and serum CRP level before and after operation in the 7th day, number of analgesic drugs, postoperative exhaust time, drainage tube time, postoperative hospital stay and total cost in group A were better than those in group B, the difference was statistically significant (P<0.05). There were significant differences in recent complications between the two groups (χ2=5.232, P<0.05). The follow-up time was 1- 4 years, and evaluated according to WHO pain grading method 1 year after operation: the effective rate of laparoscopy group (group A) was 93.8 %. In the routine laparotomy group (group B ), the effective rate was 73.7%. The treatment effect was compared the difference was statistically significant (χ2= 4.426, P<0.05). There was no significant change in diabetes and diarrhea before and after the operation.

Conclusions

If the complicated pancreatic duct stones are to be operated, laparoscopic surgery is preferred in the case of technical and equipment conditions. The principle of minimally invasive surgery should be followed in the choice of operation, so that patients can alleviate the pain and the greatest extent of benefit.

Key words: Chronic pancreatitis, Pancreatic duct stones, Laparoscope, Pancreaticojejunostomoy

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