Comparison Of Laparoscopic And Open Operation For Treating Sevre Acute Pancreatitis

Objective:To enhance the level of treatment of severe acute pancreatitis By Comparing of clinical data of laparoscopic and operation for treating sevre acute pancreatitis.Methods:A retrospective analysis of clinical data of 89 cases with SAP from 2003 to 2009 in the First Affiliated Hospital of Guangxi Medical University, which were divided into two groups laparoscopy group(22cases),Open group(67cases) according to theire operational methods. Clinical manifestation,clinieal data, lab examination, imaging outcome,local and systemic complieations,treatment and turnover were recorded. Two groups were compared in the aspects of their related indexes of SIRS scores,Ranson scores, APACHE II scores, CTSI, operation time, amount of bleeding, extent of disease in operation, hemodiastase, serum calcium, serum glucose, anodyne,ICU time, respirator time, fasting time, hospitalization periods, hospital bills, complications incidence and cure rate were analyzed as well.Results:(1) Compared with the two groups:there are no significance in severity and extent of disease in operation. There are statistical significances between the laparoscopy group and the Open group in amount of bleeding(laparoscopy group:286.6±80.1ml, Open group:356±92.2ml) hemodiastase, serum calcium, serum glucose, ICU time(laparoscopy group:9.02±6.32days, Open group:12.52±8.31 days), respirator time(laparoscopy group:9.52±6.22days, Open group:12.95±8.21 days), hospitalization periods and hospitalization periods after operation. p<0.05, Laparoscopy group was prior to Open group.In addition, the anodyne in laparoscopy group wer less than in Open group(laparoscopy group:tramadol 126.8±69.2mg, Sauteralgy20.4±11.2mg;Open group:tramadol 256.2±105.1mg, Sauteralgy40.2±30.1mg). p<0.05; (2) Laparoscopy group was prior to Open group in cure rate(p<0.05) and complications incidence especially pulmonary infection(p<0.05).Conclusion:(1) Laparoscopic operation is prior to Open operation in cure rate and complications incidence especially pulmonary infection. (2) Though laparoscopic operation is equa with Open operation in hospital bills, laparoscopic operation less than Open operation in hospitalization periods. (3) There are more advantages for treating severe acute pancreatitis with laparoscopy, such as less injury and pain, less complication, recovered soon,good cosmetic result. (4) Laparoscopy usually need more time in operation.It may be causes by learning curve.