重症急性胆管炎的急诊腹腔镜治疗

目的总结运用腹腔镜胆总管切开取石T管引流术急诊治疗重症急性胆管炎（acute cholangitis ofsevere type,ACST）的治疗经验。方法1993年9月至2006年12月间,运用腹腔镜胆总管切开取石T管引流术的手术方式（包括胆总管切开,胆管镜取石,T管引流等）有选择地对45例重症急性胆管炎患者进行急诊手术治疗。结果重症急性胆管炎45例中,急诊完成腹腔镜胆总管切开取石T管引流术45例,无中转开腹。术后胆漏2例,应激性溃疡出血1例;术后死亡1例。术后其他多种并发症均经非手术综合疗法治愈。结论只要选择合适的病例,腹腔镜胆总管切开取石T管引流术急诊治疗重症急性胆管炎,对于有较高胆管镜和腹腔镜技术者是可行、有效和安全的。

Emergency laparoscopic treatment for acute cholangitis of severe type

Objective To summarize the experience of laparoscopic choledocholithotomy with T-tube drainage for acute cholangitis of severe type(ACST).MethodsFrom September 1993 to December 2006,forty-five cases with ACST were undergone the operation.Main methods included choledochotomy,choledochoscopic exploration and T-tube drainage.ResultsOf 45 cases with ACST,45 were undergone emergency laparoscopic treatment,no cases were shifted to open CBD exploration.Bile leakage of 2 cases and hemorrhage of ulcer of 1 cases were cured postoperatively.One cases died postoperatively.ConclusionIf patients are suitable,laparoscopic choledocholithotomy with T-tube drainage for ACST is safe and efficacious for a skilled doctor.