重症急性胆管炎的急诊腹腔镜治疗

目的:总结腹腔镜胆总管探查T管引流术急诊治疗重症急性胆管炎的经验。方法:1993年9月至2007年10月,运用腹腔镜胆总管探查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51例重症急性胆管炎的患者进行急诊手术治疗。结果:重症急性胆管炎51例中,急诊完成腹腔镜胆总管切开取石T管引流术51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).Methods:From September 1993 to October 2007,there were 51 cases with ACST undergoing operation.Main methods included choledochotomy,choledochoscopic exploration,and T-tube drainage.Results:Of 51 cases with ACST,51 had operation emergency and laparoscopic operation.After operation 2 cases had bile leakage,and bleading from stress ulcer 1 case,and they all recovered.One cases died after operation.Conclusion:If patients are suitable,laparoscopic choledocholithotomy with T-tube drainage for ACST was safe and effective.