摘要
目的探讨经胆囊造瘘管处理胆囊及胆管结石的有效性、安全性及可行性。方法回顾性分析2012年1月至2016年12月采取经胆囊造瘘管治疗的17例胆囊及胆总管结石患者的临床资料。结果17例均成功实施经皮经肝胆囊穿刺置管引流术(PTGD),术后临床症状缓解率88.2%(15/17)。PTGD及瘘道扩张术后未出现出血、胆漏等并发症。胆囊及胆总管结石取净率100%,取石术后发生胆囊渗血11.7%(2/17)、胰腺炎5.9%(1/17)、高淀粉酶血症5.9%(1/17)。治疗周期(87.8±16.0)d,住院(5.5±0.6)次及(43.3±4.5)d,费用人民币(6.0±0.8)万元,手术(6.9±0.9)次,取石(1.4±0.6)次,取石时间(58.4±21.2)min。结论经胆囊造瘘管处理胆囊及胆总管结石有效、安全、可行,但是存在治疗周期长、住院及手术次数多、费用高等缺点。
Objective To investigate the efficacy, feasibility and safety of treatment of gallbladder and common bile duct stones treated through cholecystostomy tube. Methods The clinical data of 17 patients with gallbladder and common bile duct stones treated through cholecystostomy tube from January 2012 to December 2016 was analyzed retrospectively. Results Seventeen patients were successfully treated with percutaneous transhepatic gallbladder (PTGD), and 88.2% (15/17) patients had clinical symptom relief. There was no complication happened after PTGD and fistula expansion. All the stones were removed and there was 11.7% (2/17) of gallbladder bleeding, 5.9% (1/17) of pancreatitis, and 5.9% (1/17) of hyperamylasemia after stones extraction. The patients had gone through an average treatment period of 87.8±16.0 days, hospitalization of 5.5±0.6 times and 43.3±4.5 days, cost of 60.0±8.0 thousand, 6.9±0.9 operations, 1.4±0.6 stone extraction operations with the average time of 58.4±21.2 min. The duodenal papillary balloon dilatation rate was 82.4% (14/17). Conclusion The treatment through cholecystostomy tube is an effective, safe and feasible technique for gallbladder and common bile duct stones. However, there are many shortcomings such as long treatment cycle, large number of hospitalization and operations, difficult operation and high cost.
作者
张诚
马跃峰
杨玉龙
胡海
赵刚
林美举
张洪威
Zhang Cheng;Ma Yuefeng;Yang Yulong;Hu Hai;Zhao Gang;Lin Meiju;Zhang Hongwei(Cholelithiasis Disease Center,Tongji University Affiliated Shanghai East Hospital,Shanghai 200120, China;Department of Biliary Minimally Invasive Surgery,Affilated Zhongshan Hospital of Dalian University, Dalian 116001,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第4期288-290,共3页
National Medical Journal of China
关键词
经皮经肝胆囊穿刺引流术
胆道镜
胆囊结石
胆总管结石
十二指肠乳头扩张术
Percutaneous transhepatic gallbladder drainage
Choledochoscopy
Gallbladder stone
Common bile duct stone
Duodenal papillary balloon dilatation