胆道结石并急性胆管炎256例诊治体会

Experience in treating 256 cases of biliary calculi associated with acute cholangitis

目的探讨胆道结石并急性胆管炎的临床表现和治疗。方法回顾性分析我院1995年2月至2005年12月收治的256例胆道结石并急性胆管炎的临床资料。92例行保守治疗,其中65例症状缓解后择期手术。164例在发病48h内行胆总管切开取石并T管引流术。结果本组病人治愈218例,症状缓解出院27例,死亡6例,因病情恶化放弃治疗5例。结论早期诊断对胆道结石合并急性胆管炎的治疗尤为关键。及时判断胆道系统梗阻的部位及程度,尽早手术解除胆道梗阻并引流以降低胆道内的压力有利于防止重症胆管炎的发生。

Objective To study associated with acute ch the clinical features and treatment of biliary calculi From February 1995 to December 2005, 256 cases with biliary calculi associated with acute cholangitis were analyzed retrospectively. 92 cases were treated by conservative treatment and among them, 65 cases were treated by selective treatment after symptomatic relief. 164 cases were treated by surgical operation within 48 hours. Results 218 cases were cases were cured in this group. The symptoms of 27 cases were relieved to discharge from hospital. 6 cases died. Giving up treatment was in 5 cases because of patient＇s exacerbation. Conclusion Early diagnosis is very improtant for the treament of biliary calculi associated with acute cholangitis. Obstruction of biliary tract in the position and degree should be judged in time. To remove dbstruction and drain the biliary tract as early as possible is useful to prevent the acute obstrctive suppurative cholangitis.