十二指肠镜与传统治疗对胆囊切除术后胆瘘疗效的比较分析

Contrast analysis of duodenoscopic treatment and traditional treatment for bile leakage after cholecystectomy

目的比较传统治疗与十二指肠镜诊治胆囊切除术后胆瘘的效果。方法 35例胆囊切除术后胆瘘患者分为十二指肠镜组(采用十二指肠镜下逆行胆胰管造影技术诊治胆瘘,n=17)和传统治疗组(采用保守治疗和手术治疗胆瘘,n=18),比较两组胆瘘部位明确比例、胆瘘治愈时间、再次手术比例和并发症发生率。结果十二指肠镜组胆瘘部位明确比例显著高于传统治疗组(76.47%和38.89%,P<0.05),胆瘘治愈时间显著短于传统治疗组[(13±3)d和(23±5)d,P<0.05],再次手术比例显著低于传统治疗组(11.76%和38.89%,P<0.05),并发症发生率显著低于传统治疗组(17.65%和38.89%,P<0.05)。结论与传统治疗相比,十二指肠镜诊治胆囊切除术后胆瘘具有微创、安全、疗效确切等优点。

Objective To compare the effects of duodenoscopic treatment and traditional treatment on bile leakage after cholecystectomy. Methods Thirty-five patients with bile leakage after cholecystectomy were divided into duodenoscopic treatment group（managed with endoscopic retrograde cholangiopancreatography method,n=17） and traditional treatment group（managed with conservative therapy and surgery,n=18）.The percentages of bile leakage location confirmation,time of bile leakage closure,re-operation rates and prevalences of complications were compared between two groups. ResultsThe percentage of bile leakage location confirmation in duodenoscopic treatment group was significantly higher than that in traditional treatment group（76.47% vs 38.89%,P0.05）,the time of bile leakage closure in duodenoscopic treatment group was significantly shorter than that in traditional treatment group [（13±3） d vs（23±5） d,P0.05],the re-operation rate in duodenoscopic treatment group was significantly lower than that in traditional treatment group（11.76% vs 38.89%,P0.05）,and the prevalence of complications in duodenoscopic treatment group was significantly lower than that in traditional treatment group（17.65% vs 38.89%,P0.05）. Conclusion Compared with traditional treatment,duodenoscopic treatment for bile leakage after cholecystectomy is less invasive,more safe and more effective.