摘要
目的探讨经皮经肝胆管内外引流联合球囊扩张治疗胆肠吻合口良性狭窄的手术成功率及安全性。方法回顾性分析经皮胆管介入治疗的胆肠吻合口良性狭窄患者36例临床资料,记录手术成功率、术后临床表现、肝功能及黄疸指标变化、手术相关并发症及处理对策。结果36例患者中,32例一次性完成经皮胆管内外引流联合胆管球囊扩张治疗,手术成功率88.9%。患者术后主要临床表现有发热、腹痛、恶心呕吐。24例术后出现胆管感染(其中2例有感染性休克),6例出现胆管出血,3例出现电解质紊乱,1例出现胸腔积液。所有患者经积极对症处理后均好转出院。结论经皮胆管内外引流联合胆管球囊扩张治疗胆肠吻合口狭窄手术成功率高、较为安全,但术后较高的并发症如胆管感染应予以重视。
Objective To investigate the surgical success rate and safety of percutaneous transhepatic bile duct internal and external drainage combined with balloon dilatation in the treatment of benign biliary-enteric anastomotic stricture.Methods The clinical data of 36 patients with benign biliary anastomosis stenosis treated by percutaneous bile duct intervention were retrospectively analyzed.The success rate of surgery,postoperative clinical manifestations,changes in liver function and jaundice indicators,surgery-related complications and treatment strategies were recorded.Results Among the 36 patients,32 patients completed percutaneous internal and external bile duct drainage combined with bile duct balloon dilatation at one time,and the surgical success rate was 88.9%.The main clinical manifestations of the patient were fever,abdominal pain,nausea and vomiting.Bile duct infection occurred in 24 cases(2 cases had septic shock),6 cases had bile duct hemorrhage,3 cases had electrolyte disturbance,and 1 case had pleural effusion.All patients improved and discharged after active symptomatic treatment.Conclusion Percutaneous internal and external bile duct drainage combined with bile duct balloon dilatation for the treatment of biliary anastomosis stenosis has a high success rate and is relatively safe.However,high postoperative complications such as bile duct infection should be taken seriously.
作者
王向东
葛乃建
何成建
张小锋
韩一平
杨业发
WANG Xiangdong;GE Naijian;HE Chengjian(Department of Interventional Radiology,Shanghai Eastern Hepatobiliary Surgery Hospital,Shanghai 200438,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第8期1639-1642,共4页
Journal of Clinical Radiology
基金
国家自然科学基金面上项目(编号:31971249)
上海市科委基金项目(编号:14411967500)
关键词
吻合口狭窄
胆肠吻合术
经皮经肝胆管引流
球囊扩张
Anastomotic stricture
Choledochojejunostomy
Percutaneous transhepatic cholangic drainage
Balloon dilatation
