The Study of Laparoscopic-assisted Percutaneous Catheter-directed Drainage to Treat Early Severe Acute Pancreatitis
The Study of Laparoscopic-assisted Percutaneous Catheter-directed Drainage to Treat Early Severe Acute Pancreatitis
The purpose of this study is to analyze the effect of laparoscopic-assisted percutaneous
 catheter drainage of early SAP(severe acute pancreatitis).We are going to select 60 cases SAP
 patients from April 2014 to April 2015 who carry on the treatment in our hospital,and divide
 into the experimental group and control group under respect the wishes of patient in the
 case.The experimental group use the method of laparoscopic-assisted percutaneous drainage to
 carry on the treatment,the control group patients use conventional conservative therapy to
 carry on the treatment.Contrastive analyze two groups of patients clinical care effects.

 Research hypothesis:according to compare the mortality,the incidence of complications
 ,hospital stay and other research indicators of two groups .It is supposed that the research
 indicators of experimental group are lower than the control group ,difference was
 statistically significant(P<0.05).We can draw the conclusion that the method of
 laparoscopic-assisted percutaneous catheter drainage of early SAP is useful and deserve to be
 promoted on clinical.
According to the unified inclusion and exclusion criteria,We are going to select 60 cases SAP
 patients who carry on the treatment in our hospital from April 2014 to April 2015,and divide
 into the experimental group and control group under respect the wishes of patients.

 The experimental group use the method of laparoscopic-assisted percutaneous catheter-directed
 drainage of SAP.According to different causes,.For patients with simple gallbladder stones,it
 is going to carry out by laparoscopic cholecystectomy or cholecystotomy.For patients with
 both gallbladder and common bile duct stones,common bile duct exploration is
 performed.Removing necrotic pancreatic organizations and putting the catheter around the
 region of pancreas.After the surgery,patient's cavity are continuously douched by catheter
 using 0.5% 5-fluorouracil normal saline.The postoperation therapeutic program is same as the
 control group.

 The control group use the method of conventional conservative therapy without surgical
 management,the principles of treatment include:(1)fasting,insert gastric
 tube,gastrointestinal decompression;(2)complement of blood volume,keeping water ,electrolyte
 and acid base balance;(3)inhibiting pancreatic enzyme and acid secretion;(4)using
 broad-spectrum antibiotic at the early phase;(5)improving microcirculation,dextrans and
 FuFangdanshen by IV;(6)early parenteral nutrition;(7)treatment by chinese herbs;(8)strengthen
 the function of important organs.

 Contrastive analyse two groups of patient's mortality,the incidence of complications,hospital
 stay,laboratory tests and other research indicators.
Inclusion Criteria:Possessing the clinical performance and biochemical changes of acute
 pancreatitis,as well as one of the following items:

 -  organ dysfunction(one organ or multiple organs)

 -  local complications(pancreatic necrosis;pancreatic abscess;pancreatic
 pseudocyst);Ronson score of ≥3;

 -  APACHE-Ⅱscore of ≥8;

 -  Balthazar CT grade D or grade E.

 Exclusion Criteria:

 -  mild acute pancreatitis;

 -  chronic acute pancreatitis;

 -  on admission has received surgical treatment;

 -  pregnant and lactating women ;combined with heart,lung,liver,kidney severe primary
 disease;psychopath;

 -  malignant tumor

 -  immunocompromised state.