急性胆囊炎穿孔的诊治分析

Diagnosis and Treatment of Acute Cholecystitis Perforation

目的:探讨急性胆囊炎穿孔的诊断和治疗。方法:回顾性分析和总结21例急性胆囊炎穿孔患者的诊断和治疗的临床资料。结果:胆囊造瘘术14例,胆囊切除术加胆总管切开取石术7例,术后发生切口感染3例,死亡1例,死亡率4.8％(1/21)。结论:根据右上腹剧烈疼痛、全腹膜炎体征、腹腔穿刺抽出胆汁样脓液可作出初步诊断。手术以简单、快速、恢复胆道通畅为原则。

Objective:To probe into the diagnosis and treatment of acute cholecystitis perforation. Methods: The clinical date on the diagnosis and treatment of 21 cases with acute cholecystitis perforation were retrospectively summarized and analysed. Results: 14 cases had fistulization in gallbladder,7 cases had cholecystectomy plus choledochendysis in order to take the stones out.3 cases developed infection after operation,and 1 case died.The mortality was 4.8% (1/21) .Conclusion:The diagnosis can be made on the right epigastric severe pain,general peritonitis sign,abdominal paracentesis and billiary pus drawn.The operation should be performed in simple and high-speed way and on the principle of restoring the bile ducts to clear status.