腹腔镜胆囊切除术后迟发性胆漏行经内镜鼻胆管引流术的效果  

Effect of Laparoscopic Cholecystectomy Delayed Bile Leakage with Endoscopic Biliary Drainage

作　　者：崔学东 许勇 刘新星 

机构地区：[1]山东省禹城市中医院外科,禹城257200

出　　处：《中国医药导刊》2017年第2期141-143,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:分析经内镜鼻胆管引流术治疗腹腔镜胆囊切除后迟发性胆漏效果,为临床治疗提高参考。方法:选取我院2013年7月~2015年9月收治的腹腔镜胆囊切除术后胆漏患者96例为研究对象,患者经内镜鼻胆管引流术治疗,分析患者治疗效果。结果:所有患者均顺利完成手术,无中转开腹患者,12例患者放置负压引流。胆漏患者经内镜鼻胆管引流术治疗,腹膜炎症和体征逐渐消失,炎症平均消失时间(1.2±0.3)d,腹腔引流液每天减少至少5ml,腹腔引流管顺利拔出,拔出引流管时间4~10d,平均为(6.3±2.1)d。鼻胆管放置5~11d,平均为(7.6±2.8)d。住院时间10~15d,平均为(12.6±3.8)d。所有患者均康复出院,术后对患者开展6月以上随访,随访期间未出现胆管狭窄、胆漏情况。结论:腹腔镜胆囊切除术后出现迟发性胆漏发生率较高,经内镜鼻胆管引流术时治疗迟发性胆漏有效方法,安全性高,仅仅采取咽部局部麻醉,无需开腹手术治疗,引流效果好,能够降低并发症的发生。Objective：To analyze the effect of laparoscopic cholecystectomy delayed bile leakage with endoscopic biliary drainage,and provide reference for clinical treatment.Methods：96 patients with laparoscopic cholecystectomy delayed bile leakage in hospital from July 2013 to September 2015 were selected,patients were taken trentment of endoscopic biliary drainage,treatment effect of patients were compared.Results：All patients were successfully operated without laparotomy patients,12 patients place suction drainage.Bile leakage patients after endoscopic biliary drainage treatment,peritonitis and signs gradually disappear,inflammation disappears average time（1.2±0.3）d,peritoneal fluid drainage by at least 5 ml per day,peritoneal drainage tube smoothly pulled out,pull out the drainage tube time 4-10d,the average（6.3 ± 2.1）d.Nasobiliary Place 5-11d,the average（7.6 ±2.8） d.Hospitalization time 10 -15 d,an average of（12.6 ±3.8）d.All patients were discharged after surgery the patient to carry out at least 6 months of follow-up,no bile duct stricture,bile leakage cases during follow-up.Conclusion：Laparoscopic cholecystectomy bile leakage tardive higher incidence of delayed bile leakage effective treatment methods,safe when endoscopic nasal biliary drainage,just take pharyngeal local anesthetic,without open surgery drainage effect,can reduce the incidence of complications.

关 键 词：腹腔镜胆囊切除术 内镜 鼻胆管引流术 迟发性胆漏 

分 类 号：R657.4[医药卫生—外科学]