急诊开腹手术治疗结石急性梗阻化脓性胆管炎

Effects of emergency laparotomy for acute obstructive suppurative cholangitis calculus

目的 比较急诊开腹手术与急诊内镜介入治疗结石急性梗阻化脓性胆管炎的疗效.方法 回顾性分析30例结石急性梗阻化脓性胆管炎患者资料.其中,15例行急诊开腹手术胆总管切开取石＋T管引流（保留组）,15例行急诊开腹胆总管切开取石＋T管引流加胆囊切除术（切除组）,比较两组治疗效果.结果 两组患者均成功实施治疗.切除组术中出血量（128.32±46.17）mL,住院时间（7.3±3.6）d;保留组分别为（148.13 ±2.07）mL,（8.5±2.9）d,两组差异均有统计学意义（t=13.75、8.73,均P＜0.05）.结论 急诊开腹胆总管切开取石＋T管引流加胆囊切除术的损伤大于急诊开腹手术胆总管切开取石＋T管引流治疗的同时并不能临床获益,对于急性梗阻化脓性胆管炎应选择急诊开腹手术胆总管切开取石＋T管引流治疗方式.

Objective To compare the effect of emergency abdominal surgery and emergency endoscopic treatment of acute obstructive suppurative cholangitis stone.Methods A retrospective analysis of acute obstructive suppurative cholangitis stones were carried out within 30 cases.Among them,15 patients underwent emergency laparotomy choledocholithotomy ＋ T-tube drainage,15 underwent routine emergency laparotomy choledocholithotomy ＋ T tube drainage and cholecystectomy.Results All patients were successfully implemented treatment.In resection group,blood loss was （128.32 ±46.17） mL,with average length of stay （7.3 ±3.6） days.Blood loss was significantly higher than the amount retained （148.13 ± 2.07） mL（t =13.75,P 〈 0.05） ; average length of stay （8.5 ± 2.9） days （t =8.73,P 〈 0.05）,the difference was statistically significant.Conclusion Emergency laparotomy choledocholithotomy ＋ T tube drainage and cholecystectomy is not superior efficacy of emergency laparotomy choledocholithotomy ＋ T tube drainage treatment.