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中华普通外科学文献简介:中华普通外科学文献简介,中华普通外科学文献简介[详细]

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首页 > 期刊列表 > 消化道重建术后肝内外胆管结石经皮经肝胆道镜治疗的临床分析
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标题: 消化道重建术后肝内外胆管结石经皮经肝胆道镜治疗的临床分析
摘要:

目的:探讨消化道重建术后肝内外胆管结石经皮经肝胆道镜(PTCS)治疗的临床价值。方法:回顾性分析2014年3月至2018年6月什邡市人民医院行PTCS治疗的26例消化道重建术后肝内外胆管结石患者临床资料,分析PTCS临床治疗效果。结果:3例术中扩张瘘管时误操作导致瘘管断裂后中转开腹,手术中转率为11.54%(3/26)。23例手术成功,成功率88.46%(23/26),其中1次取净结石9例(39.13%),2次6例(26.09%),3次6例(26.09%),4次2例(8.70%)。术后患者间接胆红素(IBIL)、直接胆红素(DBIL)和总胆红素(TBIL)均显著低于术前水平,差异有统计学意义(P<0.05)。随访8~41(19.03±4.06)个月,结石复发率为26.92%(7/26),再次行PTCS取石治疗,随访期间未再次复发。围手术期无一例死亡,并发症发生率为11.54%(3/26),其中1例术中胆道壁损伤后大量出血,2例术后发生胆管炎,给予对症治疗措施后好转。结论:PTCS是治疗消化道重建术后肝内外胆管结石的有效手段。

英文摘要: Objective:To discuss the effects of percutaneous transhepatic cholangioscopy (PTCS) for intrahepatic and extrahepatic bile duct stones after digestive tract reconstruction. Methods:A retrospectively analyze was made on the clinical data of twenty-six patients with intrahepatic and extrahepatic bile duct stones after digestive tract reconstruction treated by PTCS from March 2014 to June 2018 in Shifang People’s Hospital, and the clinical therapeutic effect of PTCS was evaluated. Results:Three cases (11.54%) were converted to open surgery after fistula rupture due to misoperation during fistula dilation. The success rate of the operation was 88.46% (23/26), and calculi were taken out once in nine cases (39.13%), twice in six cases (26.09%), three times in six cases (26.09%), four times in two cases (8.70%). The levels of indirect bilirubin (IBIL), direct bilirubin (DBIL) and total bilirubin (TBIL) of patients after operation were significantly lower than those before operation (P<0.05). The stone recurrence rate was 26.92% (7/26) after 8-41 (19.03±4.06) months of follow-up, and PTCS was performed again. No recurrence or death occurred during the follow-up period. The incidence of perioperative complications was 11.54% (3/26), one case had massive bleeding due to injury of biliary wall during operation and two cases had cholangitis after operation. The complications were improved after symptomatic treatment. Conclusion:PTCS is an effective method for the treatment of intrahepatic and extrahepatic bile duct stones after digestive tract reconstruction.
作者:

张平;李方洪;叶发钧

作者单位: 四川省什邡市人民医院普外科
期刊: 中华普通外科学文献(电子版)
年.卷(期):页码 2020 .14(3):204-206
中图分类号:
文章编号:
引用格式: [1]张平;李方洪;叶发钧.消化道重建术后肝内外胆管结石经皮经肝胆道镜治疗的临床分析[J/CD].中华普通外科学文献(电子版),2020,14(3):204-206 .
关键词: 胆结石;消化道重建;经皮经肝胆道镜;肝功能
英文关键词: Cholelithiasis; Digestive tract reconstruction; Percutaneous transhepatic cholan-gioscopy; Liver function

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