急诊腹腔镜胆道探查术治疗高龄危重急性胆管炎  

Laparoscopic common bile duct exploration for acute severe cholangitis in elderly patients

作　　者：贾宝兴[1] 谭璐东[1] 周奕彤[2] 金哲[1] 刘亚辉[1] 

机构地区：[1]吉林大学第一医院肝胆胰外二科,长春130021 [2]长春医学高等专科学校

出　　处：《中华普通外科杂志》2016年第11期921-923,共3页Chinese Journal of General Surgery

摘　　要：目的探讨急诊腹腔镜胆道探查术治疗高龄危重急性胆管炎的临床可行性。方法回顾性分析我科近3年诊断为急性胆管炎，且8h内急诊行腹腔镜胆道探查术的高龄危重患者．分析患者的围手术期相关资料，如生命体征和化验指标变化、手术并发症等，以及所有患者预后和随访情况。结果所有患者均顺利完成腹腔镜胆道探查术，术前及术后24h心率、体温、白细胞计数及总胆红素对比差异有统计学意义（分别t=24．214，19．621，15．557，9．943，均P〈0．05）；术后3例患者出现轻度胆瘘，经通畅引流等保守治疗后好转，1例患者出现腹腔出血，24h内再次腹腔镜探查止血后好转；所有患者均顺利康复出院，未见严重心肺相关并发症；所有患者均获随访。随访期间有4例患者胆管结石复发。结论高龄危重急性胆管炎患者行急诊腹腔镜胆道探查术是安全可行的治疗手段。Objective To evaluate laparoscopic common bile duct exploration in treatment of acute severe cholangitis in patients 〉 65 years. Methods In this study, 68 elderly patients of acute severe cholangitis underwent emergency laparoseopie common bile duct exploration within 8 hours of admission. Results Emergency exploration was sueeesful in all patients. After surgery vital signs and lab test, including heart rate,temperature,leukocyte and total bilirubin were back to normal. 3 patients experiencing mild biliary fistula were cured by conservative treatment. In one patient postoperative intra-abdominal bleeding was cured by re-operation. All patients were discharged and 4 patients suffered from bile duct stones recurrence during follow up. Conclusions Emergency laparoseopie common bile duct exploration for acute severe cholangitis in elderly patients is safe, effective and feasible .

关 键 词：胆管炎 腹腔镜 急诊处理 

分 类 号：R657.4[医药卫生—外科学]