急性胆管炎内镜置管引流162例体会

Review of 162 cases of Acute Cholangitis With nasobiliary drainage

文章总结了１６２例因胆石引起的急性胆管炎采用内镜置管引流的临床体会。１４３例引流通畅，胆汁引流量２００～６００ｍｌ／ｄ，病人症状在置管后迅速缓解，可以达到急诊手术引流的效果。１２例导管未能通过高位梗阻部位，７例胆管内大量结石，泥沙及脓性絮状物堵塞导管引流不畅，而中转手术。作者认为：成功的置管引流，胆道减压迅速，可有效地控制感染，改善中毒症状并减轻黄疸。急性期后，可应用导管造影明确胆道系统的病理改变，及滴入药物治疗或溶石。内镜置管可重复，并发症少，为择期进行确定性治疗创造条件。

The experience of endoscopic nasobiliary drainage (ENBD)in 162 cases of acute cholangitis due to cholelithiasis was summarized in this article. of them,143 cases had successful drainage with 200-600/d bile,symptoms relieved as rapidly as the effect gained in emergency choledochostomy. While in the ENBD failure patients, 12 cases with high obstruction and 7 cases with a deal of calculi of pus obstruction.The successful drainage can lower the biliary pressure rapidly. control infection efficiently,and relieve toxication of jaundice effectively. After the acute onset,cholangiography can be performed through this draining tube,and the diagnosis is definited. The ENBD can be repeated with lese complications and provided a suitable condition for following radical treatment.