Clinical analysis of severe acute pancreatitis complicated with acute acalculous cholecystitis:a 39 cases report / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To summarize the clinical characteristics of severe acute pancreatitis(SAP)complicated withacute acalculous cholecystitis(AAC).METHODS: The clinical data of 141 SAP patients admitted in the First Affiliated Hospital of Harbin Medical University from September 2012 to August 2017 were analyzed retrospectively. Among them,39 SAP patients were complicated with AAC. The clinical characteristics and key points of diagnosis and treatment ofSAP complicated with AAC were analyzed and compared with the basic data and treatment of patients without AAC.RESULTS: The incidence of SAP complicated with AAC was 27.7%(39/141). Compared with the non-AAC group,theAAC group had statistically significant differences in age [(48.8±12.5)years vs.(41.4±10.9)years], Balthazar CTSIscore [(6.8±1.3)vs.(5.7±1.3)],diabetes mellitus(35.9% vs. 18.6%), fasting time [(16.9±9.5)h vs.(12.2±7.6)h],incidence of ARDS(74.3% vs. 54.9%)and ARF(43.6% vs. 23.5%),and length of hospital stay [(33.7±19.6)d vs.(21.9±12.9)d](P<0.05). In the AAC group,8 patients underwent conservative treatment. 31 patients underwent invasivetreatment for severe gallbladder inflammation,among them 20 patients received PTGD and their condition improved. Themortality rates of patients in the AAC group were also higher than that in the non-AAC group(20.5% vs. 8.8%),butthere was no statistical significance(P=0.106).CONCLUSION: The AAC is one of the common complications in the latecourses of SAP. Early diagnosis and individualized treatment are crucial to improve the curative effects. For the patients,the early use of PTGD is a safe and effectivetreatment method,which is worthy of promotion.