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三镜联合分期手术治疗急性重症胆管炎临床分析 被引量:2

Clinical analysis of three endoscopes combined with staged surgery in the treatment of acute severe cholangitis
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摘要 目的扶探讨腹腔镜、胆道镜、十二指肠镜三镜联合分期治疗急性重症胆管炎的方法及临床意义。方法去选取2019年7月~2022年12月期间对72例胆囊结石合并胆总管结石导致急性重症胆管炎患者随机分为观察组和对照组,每组各36例。观察组实施了内镜下经乳头引流,择期行腹腔镜胆囊切除+胆总管探查术,对照组急诊行腹腔镜胆囊切除、胆总管探查术。比较两组手术时间、术中出血量、术后肠道功能恢复时间、术后住院时间、并发症发生率、结石残石率等。结果果两组患者术后胆漏和结石残留方面比较差异无统计学意义(P>0.05)。观察组手术时间、术中出血量、肠道功能恢复和术后住院时间明显低于对照组,差异具有统计学意义(P<0.05)。结论三镜联合分期治疗急性重症胆管炎,安全有效,恢复快,对患者创伤小,也最大程度的符合目前现代外科的损伤控制理念。 To explore the method and clinical significance of laparoscopy,choledochoscopy and duodenoscopy in the treatment ofacute cholangitis of severe type.Method 72 patients with acute cholangitis of severe typecaused by cholecystolithiasis and choledocholithiasis from July 2019 to December 2022 were randomly divided into observation group(n=36)and control group(n=36).Endoscopic transpapillary drainage was performed in the observation group,laparoscopic cholecystectomy and common bile duct explorationwere performed in the observation group,and laparoscopic cholecystectomy and common bile duct exploration were performed in the control group.The operation time,intraoperative blood loss,postoperative intestinal function recovery time,postoperative hospital stay,incidence of complications and residual stone rate were compared between the two groups.Results There was no significant difference in postoperative bile leakage and residual stones between the two groups(P>0.05).The operation time,intraoperative blood loss,recovery of intestinal function and postoperative hospital stay in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Three endoscopes combined with staging treatment of acute severe cholangitis is safe and effective,rapid recovery,less trauma to patients,and to the greatest extent in line with the current concept of injury control in modern surgery.
作者 蔡军 刘学停 盛明辉 郑多安 孙艳军 孙登群 CAl Jun;LIU Xue-ting;SHENG Min-hui(Department of General Surgery of Anhui Provincial General Hospital of Armed Police,Hefei230041,China)
出处 《肝胆外科杂志》 2023年第3期201-204,共4页 Journal of Hepatobiliary Surgery
关键词 十二指肠镜 腹腔镜 胆道镜 急性重症胆管炎 内镜下经乳头引流 duodenoscopy laparoscopy choledochoscopy acute cholangitis of severe type endoscopic transpapillary drainage
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