反流性胆管炎的外科治疗

目的探讨反流性胆管炎的诊断和治疗方法。方法回顾性分析7年间手术治疗反流性胆管炎60例患者的临床资料。其中自发性反流性胆管炎42例，医源性反流性胆管炎18例。结果13例发生术后并发症，其中胆外瘘6例，切口感染3例，粘连性肠梗阻和膈下感染各2例。2例膈下感染分别经穿刺引流和手术引流治愈，另11例经非手术治疗痊愈。无手术死亡。55例（91.7%）随访3~12年。疗效优42例，良9例，差2例；另2例在随访期间分别死于心肌梗死和脑出血。结论根据胆道基本病变和胆管壁缺损范围等选择不同的手术方法治疗反流性胆管炎可获得满意的效果

Surgical treatment of refluxing cholangitis

Objective To investigate the diagnosis and treatment of refluxing cholangitis.Methods Clinical data of 60 patients with refluxing cholangitis treated by surgery in recent 7 years in our hospital were reviewed retrospectively.Of the 60 patients,spontaneous refluxing cholangitis and iaotrogenic refluxing cholangitis ocurred in 42 and 18 patients respectively.Results Postoperactive complications occurred in 13 cases,including biliary fistula in 6 cases,incision infection in 2,intestinal obstruction in 2,subphrenic abscess in 2, all the complications were cured by various treatment.There was no perioperative mortality in this series.Fifty-five patients were followed-up for 2-11 years,42 were excellent,9 good and 2 poor;2 patients died of cerebral haemorrhage and myocardial infarction respectively during the follow-up period.Conclusions An appropriate operation should be chosen for patients with refluxing cholangitis according to the basic disorder and the extent of biliary duct wall deficit.