内镜下治疗急性梗阻性化脓性胆管炎

目的 探讨内镜下治疗急性梗阻性化脓性胆管炎（AOSC）的治疗方式与可行性。方法 对26例AOSC患者实施内镜治疗（研究组），先行内镜下逆行胰胆管造影术（ERCP）、内镜下十二指肠乳头括约肌切开术（EST）和（或）内镜下十二指肠鼻胆管引流（ENBD），然后根据病情不同行腹腔镜下胆囊切除术12例，胆总管切开胆道探查、T管引流术各7例。并与传统开腹手术（对照组）21例进行比较。结果 内镜治疗效果满意，全组无死亡病例。研究组较对照组的腹痛缓解时间快、治疗后7d血清总胆红素水平下降明显、住院时间短。结论 内镜下治疗急性梗阻性化脓性胆管炎是安全有效的。

Treatment of Acute Obstructive Suppurative Cholangitis under Endoscopy

Objective To explore the treatments and feasibility of acute obstructive suppurative cholangitis(AOSC) under endoscopy.Methods Twenty-six patients with AOSC(study group) were subjected to endoscopic therapy:ERCP,EST,and/or ENBD at first,then 12 patients of them to laparoscopic cholecystectomy,and 7 patients to laparoscopic choledocholithotomy and T-tube drainage according to the individualized pathogenetic condition.Twenty-one patients as control group were subjected to traditional surgical operation.Results The clinical effectiveness was satisfactory,and no one died among the patients.The relief of pain in abdomen was quicker,hospital stay was shorter and the decreased level of serum bilirubin was more obvious in study group than in control group at 7th day after the treatment.Conclusion Endoscopic therapy for AOSC is safe and effective.