临床研究(Clinical Research)

急诊腹腔镜治疗急性重症胆管炎117 例分析

Published at: 2015年第24卷第2期

郑志鹏 1 , 何军明 1 , 钟小生 1 , 黄有星 1 , 谭志健 1
1 广东省中医院/ 广州中医药大学第二附属医院 肝胆胰外科,广东 广州 510120
通讯作者 志鹏 郑 Email: zhipeng1116@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.02.019
基金:

摘要

目的:探讨急诊腹腔镜治疗急性重症胆管炎的疗效及手术操作要点。方法:回顾性分析2007 年1 月—2014 年11 月期间为117 例胆总管结石继发急性重症胆管炎行腹腔镜治疗患者的临床资料。结果:全组中110 例(94.0%)完全在腹腔镜下完成胆总管切开取石手术,7 例中转开腹;平均手术时间144 min,术中出血量53 mL;4 例术后感染性休克加重,经抗休克治疗后治愈,术后十二指肠瘘1 例,胆汁漏3 例,腹腔积液感染4 例,经引流及抗感染后治愈;平均住院时间为7.2 d。结论:在严格把握适应证及熟练掌握腹腔镜操作技术的条件下,腹腔镜治疗急性重症胆管炎是安全可行的。


Analysis of laparoscopic therapy for severe acute cholangitis in 117 cases

Abstract

Objective: To investigate the efficacy and essential technical points of laparoscopic treatment for severe acute cholangitis (SAC). Methods: The clinical data of 117 patients with SAC secondary to common bile duct stones, who underwent laparoscopic treatment during January 2010 to November 2014, were retrospectively analyzed. Results: In the entire group, 110 patients (94.0%) underwent totally laparoscopic common bile duct exploration, and 7 patients required open conversion. The mean operative time was 144 min and intraoperative blood loss was 53 mL. The septic shock was exacerbated in 4 patients after operation, which improved by antishock measures, while postoperative duodenal fistula, bile leakage and intra-abdominal collection occurred in 1, 3 and 4 cases respectively, which were resolved by drainage and anti-infective treatment. The mean length of postoperative hospital stay was 7.2 d. Conclusion: Based on rigorous medical indications and proficient laparoscopic skill, laparoscopic therapy of SAC is safe and feasible.


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引用

引用本文: 志鹏 郑, 军明 何, 小生 钟, 有星 黄, 志健 谭. 急诊腹腔镜治疗急性重症胆管炎117 例分析[J]. 中国普通外科杂志, 2015, 24(2): 254-257.
Cite this article as: ZHENG Zhipeng, HE Junming, ZHONG Xiaosheng, HUANG Youxing, TAN Zhijian . Analysis of laparoscopic therapy for severe acute cholangitis in 117 cases[J]. Chin J Gen Surg, 2015, 24(2): 254-257.