结石性急性胆管炎的治疗

Treatment of Acute Cholangitis with Hepatolithiasis

目的探讨结石性反复发作的胆管炎的治疗方法。方法回顾性分析1998年1月至2008年12月北京协和医院急诊诊治的急性胆管炎患者的临床资料,所有入选患者均具备夏柯氏三联征表现。结果共408例患者接受手术治疗,其中急诊手术167例、经介入治疗或保守治疗后择期手术241例,急诊手术术后并发症发生率为6.4%,择期手术并发症发生率为3.2%,择期手术术后30d无死亡病例。结论随着介入技术和内镜技术的进展,急性胆管炎患者由急诊手术经保守治疗或介入治疗转为择期手术,可以大大减少手术并发症发生率,降低手术死亡率。

Objective To evaluate the treatment of recurrent acute cholangitis with hepatolithiasis.Methods We retrospectively analyzed the clinical data of patients with recurrent acute cholangitis who were treated in Peking Union Medical College Hospital＇s emergency department from January 1998 to December 2008.Results Totally 408 patients underwent surgery,of which 167 patients received emergency operations and 241 underwent selective operations after medication and interventional treatment.The incidence of complications was 6.4% among those who received emergency operations and 3.2% among selective operations.The 30-day mortality rate of selective operations was zero.Conclusion Along with the progress of percutaneous cholangiographic drainage and endoscopic retrograde cholangiopancreatography,selective operations have been increasingly applied for acute cholangitis with notably low complications and postoperative death.