外科医生为患有胆石性胰腺炎的患者提供明确的治疗。

Surgeons provide definitive care to patients with gallstone pancreatitis.

机构信息

Department of Surgery, Denver Health Medical Center, the University of Colorado Denver School of Medicine, Denver, CO 80204, USA.

出版信息

Am J Surg. 2011 Dec;202(6):673-7; discussion 677-8. doi: 10.1016/j.amjsurg.2011.06.031. Epub 2011 Oct 19.

DOI:10.1016/j.amjsurg.2011.06.031

PMID:22014646

Abstract

BACKGROUND

The optimal management of patients with gallstone pancreatitis (GP) remains a matter of debate. There are wide variations in the use of diagnostic testing and same-stay cholecystectomy. We hypothesize that a general surgery service (SURG) will deliver more efficient, definitive care for patients with GP.

METHODS

A retrospective cohort study of consecutive GP patients in an urban hospital from 2006 to 2009. Differences between groups were assessed by the two-tailed Student t test for continuous variables and the Fisher exact test for ordinal data.

RESULTS

One hundred twenty-four patients with GP were admitted, 79 to medicine (MED) and 45 to surgery (SURG). In the MED group, 21 patients (27%) underwent same-stay cholecystectomy, and 7 patients (9%) returned with recurrent biliary pancreatitis. In the SURG group, 44 patients had definitive surgery, and none returned with recurrent disease (P < .01 and .09, respectively). The SURG group had fewer laboratory tests, antibiotics, and consultations.

CONCLUSIONS

For patients with GP, admission to surgery results in definitive treatment with same-stay cholecystectomy. This is a more efficient approach with fewer readmissions for the same disease process.

摘要

背景

胆石性胰腺炎（GP）患者的最佳治疗方法仍存在争议。在诊断检测和同住院期胆囊切除术的应用上存在广泛差异。我们假设普通外科服务（SURG）将为 GP 患者提供更有效、更明确的治疗。

方法

这是一项回顾性队列研究，纳入了 2006 年至 2009 年在一家城市医院连续收治的 GP 患者。通过双尾学生 t 检验比较连续变量，通过 Fisher 确切检验比较有序数据。

结果

共收治 124 例 GP 患者，其中 79 例收入内科（MED），45 例收入外科（SURG）。在 MED 组中，21 例（27%）患者接受了同住院期胆囊切除术，7 例（9%）患者因复发性胆源性胰腺炎再次入院。在 SURG 组中，44 例患者接受了确定性手术，无一例患者因复发性疾病再次入院（P<0.01 和 P<0.09）。SURG 组的实验室检查、抗生素和会诊次数更少。