摘要
目的探讨急性重症胆管炎外科治疗方式,提高治愈率,减少并发症和死亡率。方法回顾性分析56例急性重症胆管炎病人的外科治疗及预后情况。结果19例手术治疗病人均行术中胆道镜探查取石,37例行内镜括约肌乳头切开取石、鼻胆管引流术,其中3例伴有胆囊积液和颈部结石嵌顿,第2天行胆囊切除术。49例治愈,5例好转需二期手术,死亡2例。结论明确诊断后及早手术或内镜引流,合理选择术式,是提高治愈率、降低并发症和死亡率的关键。术中胆道镜探查取石可减少结石残余,内镜胆管引流后如胆囊炎症持续加重应尽早手术。
[Objective] To explore the surgical treatment of severe acute eholangitis for increasing the curative rate and reducing the morbidity and mortality. [Methods] Retrospective analysis was made on the surgical treatment and prognosis of 56 patients with severe acute cholangitis. Of all the 56 patients, 19 underwent operation using intraoperative choledochoscope and 37 underwent EST plus ENBD. Among these 37 patients, there were 3 patients accompanying acute incarcerated cystic neck stone and gallbladder empyema who received cholecystectomy in second day. [Results] 49 patients were cured and 5 patients got better but needed reoperation, while 2 patients died. [Conclusions] Timely and reasonable operation or drainage with ERCP after definite diagnosis is the key to raise curative rate, decrease morbidity and mortality. Intraoperative choledochoscope could reduce remains of stone. If cholecystitis aggravated after ENBD, a timely operation should be performed.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2007年第5期630-632,共3页
China Journal of Modern Medicine
