内镜治疗和传统治疗对胆囊切除术后胆瘘的诊治疗效对比分析

Comparisoil between ERCP and conventional treatment for bile leakage after cholecystectomy

目的对比内镜与传统方法治疗胆囊切除术后胆瘘的效果。方法回顾性分析35例胆囊切除术后发生胆瘘的患者资料，其中传统治疗组18例，采用保守治疗及手术等治疗；内镜组17例，根据病情应用十二指肠镜进行ERCP等内镜治疗。对比2组患者的胆瘘愈合时间、再次手术率、并发症发生情况等。结果传统治疗组胆瘘部位明确7例，胆瘘愈合时间平均23d，再次手术8例，发生并发症7例；内镜组胆瘘部位明确13例，胆瘘愈合时间平均13d，再次手术2例，发生并发症3例。各项指标内镜组均明显优于传统治疗组（P均〈0．05）。结论十二指肠镜能够明确胆囊切除术后胆瘘的部位、性质，能治疗大部分该类患者，并为需外科手术病例提供指导，具有微创、安全、疗效确切等优点。

Objective To compare the therapeutic result between ERCP and conventional treatment for bile leakage after cholecystectomy. Methods Data of 35 cases with bile leakage after cholecystectomy were retrospectively studied, in which 18 patients underwent conventional therapy and surgery （conventional group）, and 17 others underwent ERCP （endoscopy group）. The time of bile leakage closure, complication rate, and re-operation rate of the 2 groups were compared. Results In conventional group, leakage location was identified in 7 cases and mean bile leakage closure time was 23 days. A second operation was performed in 8 cases and complications occurred in 7. In endoscopy group, leakage location was identified in 13 cases and mean bile leakage closure time was 13 days. A second operation was performed in 2 cases and complications occurred in 3. Significant differences were found between 2 groups in regarding of the above references. Conclusion ERCP is accurate and valuable for diagnosis and treatment for bile leakage after cholecystectomy.