拔T管后腹腔内胆漏致胆汁性腹膜炎20例临床分析

Clinical analysis of 20 patients with intraperitoneal biliary leakage after removal of T-tubes from the common bile duct

目的探讨拔除T管后发生腹腔内胆漏致胆汁性腹膜炎的原因及其防治方法。方法对我院2001年4月-2008年4月行胆道探查＋T管引流术后T拔管除时发生腹腔内胆漏致胆汁性腹膜炎20例的临床资料进行回顾性分析。结果经保守治疗治愈18例，其中，经窦道置入尿管引流16例，经逆行胰胆管鼻胆管引流治愈2例；经再次手术治愈2例。结论胆漏的发生与医源性因素、使用的材料及病人的自身因素有关；大多数胆漏能通过非手术方法治愈；应严格掌握手术的适应证。

Objective To investigate the cause, prevention and treatment of intraperitoneal biliary leakage after removal of T-tubes from the common bile duct. Methods The clinical data of 20 patients with intraperitoneal bitiary leakage after removal of T-tubes from the common bile duct at our hospital from April 2001 to April 2008 were reviewed. Results Eighteen patients were cured after conservative treatment （16 patients were cured by inserting a Nelaton＇s catheter and draining. Two patients were cured by endoscopic nosalbiliary drainage）. Two cases were cured by reoperation. Conclusion Intraperitoneal biliary leakage relates to iatrogenic, material or patients ＇ factors. Most of intraperitoneal biliary leakage cases can be cured by conservative therapy. Reoperative therapy would he taken according to indication.