摘要
目的探讨胆总管结石患者中胆囊切除所占比例,胆总管结石术后再发结石及胆总管结石患者合并胆管炎的情况。方法对南京市第一医院2013年1月至2017年7月1 152例胆总管结石患者的临床资料进行回顾性分析。结果1 152例胆总管结石患者中,572例有胆囊切除手术史,占总数的49.7%;合并胆囊结石402例,占总数的34.9%,不合并胆囊结石为278例,占24.1%。胆囊切除术后可发生胆总管结石,其复发时间多在术后5~10年,为49.1%。200例胆总管结石取石术后再发胆总管结石患者中,胆总管切开取石及胆囊一并切除110例,ERCP取石术后90例,两者差异无统计学意义(P>0.05)。胆总管结石患者合并胆管炎511例,占44.3%,其中急性轻症胆管炎437例,占85.5%,急性梗阻化脓性胆管炎54例,占14.5%。胆总管切开取石后再发胆总管结石51例合并急性胆管炎,ERCP取石后再发胆总管结石患者中50例合并急性胆管炎,两组差异无统计学意义(P>0.05)。结论胆总管结石患者中胆囊切除术后占较高比例;胆总管结石取石术后仍可再发胆总管结石;胆总管结石易并发胆管炎。
Objective To analyze the incidence of choledocholithiasis in patients who underwent cholecystectomy in our hospital,and to determine the incidences of recurrent stones and choledocholithiasis combined with cholangitis after treatment for choledocholithiasis.Methods A retrospective study was conducted on 1 152 patients with common bile duct stones treated from January 2013 to July 2017 in our hospital.Results Of the 1152 patients with common bile duct stones,572 patients had a history of cholecystectomy,accounting for 49.65%of all patients.402 patients had choledocholoithiasis combined with cholecystolithiasis(34.9%of all patients),278 patients had choledocholithiasis without cholecystolithiasis(24.1%).Choledocholithiasis could occur after cholecystectomy.The time of onset of choledocholithiasis was 5~10 years after operation in 49.1%of patients,and 200 of these patients with choledocholithiasis were treated with lithotripsy.There were 110 patients who underwent choledocholithotomy and cholecystectomy,and 90 patients who underwent ERCP and stone removal.There was no significant difference between the 2 groups(P>0.05).Choledocholithiasis complicated with cholangitis developed in 511 patients(44.3%of all patients).These included 437 patients with acute mild cholangitis(85.5%)and acute obstructive suppurative cholangitis(14.5%).Recurrent choledocholithiasis combined with acute cholangitis after choledocholithotomy developed in 51 patients,and recurrent choledocholithiasis combined with cholangitis developed after ERCP in 50 patients.There was no significant difference between the two groups(P>0.05).Conclusions Choledocholithiasis after cholecystectomy accounted for a high proportion of patients.Recurrent choledocholithiasis could occur after choledocholithotomy.Common bile duct stones were susceptible to develop cholangitis.Thus,common bile duct stones should be treated as soon as possible.
作者
朱宇
董建宁
杨士勇
刘子君
Zhu Yu;Dong Jianning;Yang Shiyong;Liu Zijun(Department of General Surgery,Nanjing First Hospital,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210000,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2019年第8期579-581,共3页
Chinese Journal of Hepatobiliary Surgery
关键词
胆总管结石病
胆囊切除术
胆管炎
胰胆管造影术
内窥镜逆行
Common bile duct stones
Cholecystectomy
Cholangitis
Cholangiopancreatography,endoscopic retrograde
