Department of Surgery, Denver Health Medical Center, the University of Colorado Denver School of Medicine, Denver, CO 80204, USA.
Am J Surg. 2011 Dec;202(6):673-7; discussion 677-8. doi: 10.1016/j.amjsurg.2011.06.031. Epub 2011 Oct 19.
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.
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.
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.
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.
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。
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。
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。
对于 GP 患者，收入外科可进行确定性治疗，包括同住院期胆囊切除术。这种方法更有效，相同疾病过程的再入院率更低。
