Effect and prognosis of peri- pancreatic stepwise minimally invasive treatment in patients with severe acute pancreatitis

Objective To investigate the clinical effect and prognosis of peri- pancreatic stepwise minimally invasive treatment in patients with severe acute pancreatitis( SAP). Methods The clinical data of 110 patients with SAP who were treated in Panzhihua Central Hospital from January 2013 to December 2014 were analyzed retrospectively,and these patients were divided into two groups( 55 patients in each group) according to the treatment regimen. The patients in the control group were treated with laparotomy,and those in the study group received peri- pancreatic stepwise minimally invasive treatment. The postoperative short- term treatment outcome,Acute Physiology and Chronic Health Evaluation Ⅱ( APACHE Ⅱ) score,laboratory markers [serum amylase( AMS),white blood cell( WBC),and C- reactive protein( CRP) ],time to intestinal recovery,incidence of complications,and mortality were compared between the two groups. The t- test was applied for comparison of continuous data between the two groups,and the chi- square test was applied for comparison of categorical data between the two groups. Results Compared with the control group,the study group had significantly higher short- term marked response rate,response rate,and overall response rate( χ2= 5. 1665,4. 9865 and 5. 6357,all P < 0. 05). There were significant differences in AMS,WBC,pulse oxygen saturation( Sp O2),CRP,and APACHE Ⅱ score between the two groups at 1 week after surgery and at discharge( t =13. 6585,13. 4698,12. 0566,14. 6856,and 13. 8869 for 1 week after surgery,t = 12. 8946,14. 2683,13. 8963,14. 8989,and 13. 0986 for discharge,all P < 0. 05); there was a significant difference in WBC count on day 1 after surgery between the two groups( χ2= 12. 6984,P < 0. 05); both groups showed significant improvements in AMS,WBC,Sp O2,CRP,and APACHE Ⅱ score at 1 week after surgery and at discharge compared with the values on day 1 after surgery,and there were significant changes in these values within each group( all P <0. 05); compared with the control group,the study group had a significantly shorter time to intestinal recovery,a significantly lower mortality rate,and a significantly lower incidence of complications( pleural effusion,dyspnea,false- positive cysts,and wound infection)( t = 13. 6985,P = 0. 042,χ2= 8. 3968,5. 6357,4. 0673,4. 0371,and 4. 4071,all P < 0. 05). Conclusion Peri- pancreatic stepwise minimally invasive treatment has a significant effect in the treatment of SAP and can improve the prognosis of patients. Therefore,it holds promise for clinical application.