腹腔镜胆囊切除术后胆管炎的诊疗及预防

Diagnosis,treatment and prevention of cholangitis after laparoscopic cholecystectomy

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术后胆管炎的原因及治疗措施。方法:回顾分析2009年2月至2012年7月为118例患者行LC的临床资料,其中12例术后并发胆管炎,发生率10.17%。结果:4例患者于LC术后48 h内发现,术前CT显示胆管内泥沙样结石,胆总管轻度扩张;8例于术后72 h后发现,其中5例为急性胆囊炎患者,3例为胆囊管内小结石脱落至胆总管所致。12例均予以保守治疗,无死亡病例,均治愈出院。结论:LC术后胆管炎重在早期诊断、早治疗,选择合适的方法进行处理,可减少严重并发症的发生。

Objective ：To explore the causes and therapeutic measures of cholangitis after laparoscopic cholecystectomy （LC）. Methods ：The clinical data of 12 cases who suffered cholangitis after LC （ 118 cases of LC,with the incidence of 10.17% ） from Feb. 2009 to Jul. 2012 were retrospectively analyzed. Results： Cholangitis occurred in 4 cases within 48 h after LC, in which sandy stones were discovered in bile ducts and the common bile duct slightly dilated by CT scan. Cholangitis occurred in 8 cases within 72 h, of whom 5 cases were acute cholecystitis and 3 cases were caused by small stones in ductus cysticus moved to the common bile duct. All the 12 cases received conventional therapy and all of them were recovered. No death occurred. Conclusions：Early diagnosis and treatment was important for cholangitis after LC. Complications could be reduced if appropriate treatments were adopted.