微创化治疗急性化脓性胆管炎17例临床分析

The Clinical Analysis of Minimally Invasive Therapy to Acute Obstructive Suppurative Cholangitis

目的总结提高ERCP、PTCD治疗对急性化脓性胆管炎的紧急救治水平;方法回顾性分析我科收治的17例微创治疗急性化脓性胆管炎患者临床资料,所有患者均接受抗感染、补液等一般治疗;结果单纯行内镜下逆行胰胆管造影(ERCP)治疗的患者为14例,其中十二指肠乳头切开取石和(或)鼻胆管引流(ENBD)9例,行胆管支架置入术者5例;在行胆管支架引流的患者中,1例为肝门部肿瘤,外院行胆管支架植入术后7月余,此次引流后,其症状明显缓解,体温逐步恢复正常;经皮肝穿刺胆管引流(PTCD)的患者3例,2例治愈,1例缓解;所有患者均未出现严重并发症。结论 ERCP等微创治疗方式对急性化脓性胆管炎具创口小,较少影响患者生活质量,效果佳的优势。

Objective To improve the level of treatment which the ERCP and PTCD were applied to the Acute Obstructive Suppurative Cholangitis. Method A retrospective analysis of 17 cases of clinical data of patients with acute suppurative cholangitis which the minimally invasive treatment applied to in our hospital. Result Fourteen cases of patients received the treatment of ERCP, which among them nine eases received calculus removed and ENBD, the other five eases were drained by therapeutic ERCP for biliary duet obstruction. Among the patients who were drained by therapeutic ERCP for biliary duct obstruction, one for hepatic portal bile duct cancer, who had biliary stent for seven months. Three patients received the therapy of PTCD. All the patients had no severe complica- tions. Conehltsion The minimally invasive methods of therapeutic ERCP are good methods for AOSC.