胆石性肠梗阻的诊治(附11例临床分析)

目的探讨胆石性肠梗阻的临床特点和治疗方法. 方法我院1985年～2000年共收治胆石性肠梗阻11例,术前仅3例确诊.均经手术治疗,其中10例行肠管切开取石,1例因肠坏死切除坏死肠段.失访2例,余9例患者一期术后6～9月行胆囊切除和(或)内瘘修补术. 结果Ⅰ期手术后并发呼吸道感染2例,切口感染1例,随访结果显示Ⅱ期手术后9例患者均获治愈. 结论胆石性肠梗阻术前确诊率低,但及时的B超及X线检查有助于其早期诊断,分期手术治疗胆石性肠梗阻效果显著.

Diagnosis and Treatment of Gallstone Ileus:A Report of 11 Cases

Objective To investigate the diagnosis and treatment of gallstone ileus. Methods 11 cases of gallstone ileus were admitted from 1985 to 2000. Only 3 cases got comfirmed diagnosis before operation. All cases received laparotomy. The obstructive gallstones were removed in 10 cases by enterotomy. Enterectomy and anastomosis were performed in 1 case because of intestinal necrosis. 2 cases were lost during follow-up. The others got cholecystectomy and (/or) internal fistula neoplasty in 6 to 9 months after the primary operation. Results Respiratory tract infection occurred in 2 cases, and wound infection occurred in 1 case after the primary operation.All the 9 patients were cured by the second operation. Conclusion Seasonable abdominal film and ultrasonography play an important role in the early diagnosis of gallstone ileus. It is suitable to perform the operations by two stages.