急性梗阻性化脓性胆管炎的手术治疗研究

目的:探讨对55例急性梗阻性化脓性胆管炎的手术治疗体会。方法:以55例急性梗阻性化脓性胆管炎患者作为研究对象,采用单纯胆囊切除术、胆囊大部切除术、胆总管切开取石术、T管引流术或胆囊造瘘术进行治疗,观察疗效。结果:患者平均手术时间(2.2±0.8)h。治愈41例,好转8例,治愈率为74.5%。有4例患者发生肺部感染。1例患者发生胆总管结石残留,经T管取石后未再发现结石。有6例患者死于多器官功能衰竭(MODS)。结论:急性梗阻性化脓性胆管炎的手术治疗应根据患者情况,采用个体化的治疗方案,把握好手术时间,选择恰当的手术方式进行治疗,提高患者的生存率。

Objective ： Study of 55 cases of acute obstructive suppurative cholangitis in surgical treatment. Methods ： 55 cases of acute obstructive suppurative cholangitis in patients for the study, the use of simple cholccystectomy, subtotal resection of the gallbladder, common bile duct cut open stone surgery, T- tube drainage or cholecystostomy for treatment and followup effects were observed. Results： The mean operative time （2.2 ± 0.8） h. Cure in 41 cases, 8 cases improved, the cure rate was 74.5%. 4 patients with pulmonary infection. 1 patient had residual common bile duct stones, stone extraction through the T tube after not detected the stones. Six patients died of multiple organ failure （MODS）. Conclusion ： Acute obstructive suppurative cholangitis of the surgery should be based on the patient ＇ s condition, the use of individualized treatment programs, a good grasp of the operation time, choose the appropriate surgical treatment, improve the survival rate