经胆道镜清创处理腹腔残余感染27例的应用分析

Analysis on application of choledochoscope-guided debridement in treatment of 27 cases with residual infection in abdomen

目的探讨使用胆道镜处理腹腔残余感染的可行性。方法回顾性分析医院2013年10月~2018年10月通过胆道镜清创处理的腹腔残余感染27例,总结治疗效果及其预后。结果本研究27例中,Ⅰ型8例,Ⅱ型13例,Ⅲa型4例,Ⅲb型2例。经胆道镜清创处理后,Ⅰ型患者均治愈;Ⅱ型患者中,11例治愈,2例经腹腔镜清创后治愈;Ⅲa型患者中,2例治愈,1例再次开腹手术清创后治愈,1例经腹腔镜清创后治愈;Ⅲb型患者中,1例治愈,1例经腹腔镜清创后治愈。结论采用经胆道镜处理腹腔残余感染的方法,可避免患者再次接受开腹或腹腔镜手术,其操作简便,实用价值高,值得临床推广。

Objective To explore the feasibility of treating residual infection in abdomen by using a choledochoscope.Methods A retrospective analysis was made for 27 patients with residual infection in abdomen who received debridement under the guidance of choledochoscope in o ur hospital from October 2013 to October 2018,and the therapeutic effect and prognosis were summarized.Results All 27 cases were divided into typeⅠpatients(n=8),typeⅡpatients(n=13),typeⅢa patients(n=4)and typeⅢb patients(n=2).After debridement under the guidance of choledochoscope,all type I patients were cured directly;among the typeⅡpatients,11 patients were cured directly and two patients were cured after debridement under the guidance of laparoscope;among the typeⅢa patients,two patients were cured directly,one patient was cured after another laparotomy and debridement,and the remaining one was cured after debridement under the guidance of laparoscope;among the typeⅢb patients,one was cured directly,another was cured after debridement under the guidance of laparoscope.Conclusion Application of choledochoscope in treatment of residual infection in abdomen can prevent the patients from receiving laparotomy or laparoscopic surgery again.It is simple in operation and of high practical value,which is worthy of clinical promotion.