摘要
目的总结老年性胆总管结石症并胆管炎的临床特点以及外科手术治疗经验。方法回顾性分析近7年来86例手术的老年性胆总管结石症并胆管炎的病人。结果86例患者中68例(79.1%)并存慢性内科疾病,术前影像学检查82例明确结石的数量和部位,4例为肝内外胆管扩张而高度怀疑胆总管结石。2例急性梗阻性化脓性胆管炎在入院后1周内死于中毒性休克和全身和多器官功能衰竭,手术治疗84例,其中急诊手术34例,对症处理后择期手术50例。围手术期1例死于胆漏导致的胆汁性腹膜炎、脓毒败血症。83例术后患者均于2周胆道造影检查显示:68例(81.9%)胆总管内未见结石,16例(18.1%)仍见胆总管内结石。手术后2年内症状再次发作24例(29.0%)。结论重视围手术期处理,纠治各种夹杂症,正确把握手术适应证和手术时机,采用有效而简单的手术方式,治疗高龄胆石症也同样能取得满意的疗效。
Objective To summary the clinical characteristics and surgical experience about senial cholelithiasis complicated with cholangitis of common bile duct.Methods There were86cases senial cholelithi-asis complicated with cholangitis of common bile duct whose data were analysed retrospectively.Re sults There were68cases(79.1%)who companyed with chronic physical diseases.All cases had radiology examination and there were82cases were confirmed with the location and number of calculus in common bile duct,and still4cases who were suspected with cholelithiasis of common bile duct because of being dilated seriously.There were2cases who died of toxic shock and mutiple organ failure1week after hospitalization.There were84cases who had operation,among which34cases had emergency operation and50cases had limited operation after relatively physical treatment.There was1case who died of bile leakage,peritonitis and inflammatory shock during peri-operation.Radioscopy were preceded2weeks after operation and it showed that there were no residual calculus in68cases(81.9%),and residual calculus existed in16cases(18.1%).Twenty-four cases(29.0%)endured recurrence of cholelithiasis in2years after operation.Conclusions It is essential to emphasize on the physical treatment during peri-operation,improve the general body condition,get the best opportunity and indication of operation in order to get satisfied effect of operation for senial cholelithiasis complicated with cholangitis of common bile duct.
出处
《海南医学》
CAS
2005年第2期27-29,共3页
Hainan Medical Journal
关键词
老年
胆总管结石
胆管炎
手术
Senium
Cholelithiasis
Common Bile Duct
Cholangitis
Surgical Treatment
