湖州地区基层医院腹腔镜术中胆道造影治疗老年急性结石性胆道感染30例报告

Cholangiography in laparoscopic surgery to treat 30 elderly patients with acute calculous biliary tract infection in Huzhou primary hospitals

目的研究湖州地区基层医院腹腔镜胆囊切除及术中胆道造影在老年急性结石性胆道感染患者中的临床治疗效果,总结腹腔镜胆道造影的经验。为临床提供依据。方法选取2014年12月至2016年1月湖州地区基层医院诊治的30例老年急性胆道感染患者资料进行回顾性分析。结果 30列老年患者手术均顺利完成,26例患者行腹腔镜胆囊切除术(LC),胆总管无明显异常;4例术中发现胆总管结石,行腹腔镜下胆道探查术;术中发现1例胆道畸形;1例胆道损伤,钛夹误夹部分胆总管壁,予取出后重新夹过;29例治愈,其中2例患者术后出现胰腺炎,予禁食、抗感染等保守治疗后治愈;1例患者术后出现心脏功能衰竭,治疗效果不佳后自动出院。结论老年急性结石性胆道感染患者采用腹腔镜胆囊切除术+术中胆道造影治疗是一种安全可靠的诊疗技术;可及时发现胆道残余结石,预防胆道损伤;效果理想,值得在基层医院中推广应用。

Objective To study the clinical effect of cholangiography in laparoscopic surgery to treat elderly patients with acute calculous biliary tract infection in Huzhou primary hospitals. Methods From2014.12 to 2016.1, 30 cases of elderly patients with acute biliary tract infection in Huzhon pri-mary hospitals were retrospective analysed. Results Laparoscopic cholecystectomy was performed in 26 patients. And laparoscopic bile duct exploration was performed in 4 patients. 4 cases of common bile duct stones, 1 cases of bile duct malformation and 1 cases of bile duct injury were found during cholangiography. 29 cases were cured, 2 cases were complicated with pancreatitis. Postoperative heart failure happened in 1 patient who against-advice discharged finally. Conclusion The treatment of cholangiography in laparoscopic surgery in elderly patients with acute calculous biliary tract infection was a safe and reliable diagnosis and treatment technology which can discover the bile duct residual stones and prevent bile duct injury in time, and should be worth popularizing and applying.