经内镜逆行性胰胆管造影术联合腹腔置管引流治疗肝胆手术后胆漏的效果

Effect of Endoscopic Retrograde Cholangiopancreatography Combined with Peritoneal Catheter Drainage in Treatment of Biliary Leakage After Hepatobiliary Surgery

目的:分析经内镜逆行性胰胆管造影术(ERCP)联合腹腔置管引流治疗肝胆手术后胆漏的临床效果。方法:选取2019年1月—2022年10月保山市第二人民医院收治的60例肝胆手术后胆漏患者作为研究对象,采用随机数字表法分为两组,各30例。对照组采取对症治疗,观察组在对照组基础上采取ERCP联合腹腔置管引流治疗。比较两组治疗效果。结果:观察组首次下床活动时间、住院时间短于对照组,差异有统计学意义(P<0.05)。治疗前,两组肿瘤坏死因子-α、C反应蛋白水平比较,差异无统计学意义(P>0.05);治疗1周后,观察组肿瘤坏死因子-α、C反应蛋白水平低于对照组,差异有统计学意义(P<0.05)。观察组治疗总满意度高于对照组,差异有统计学意义(P=0.043)。结论:ERCP联合腹腔置管引流治疗肝胆手术后胆漏的效果良好,可缩短患者下床活动时间、住院时间,加速炎性反应消退,提高治疗满意度。

Objective:To analyze the clinical effect of endoscopic retrograde cholangiopancreatography(ERCP)combined with peritoneal catheter drainage in treatment of biliary leakage after hepatobiliary surgery.Methods:A total of 60 patients with biliary leakage after hepatobiliary surgery in the Second People's Hospital of Baoshan City from January 2019 to October 2022 were selected as the study subjects.They were divided into two groups according to random number table method,with 30 patients in each group.The control group received symptomatic treatment,and the observation group received ERCP combined with peritoneal catheter drainage treatment on the basis of control group.The therapeutic effects were compared between the two groups.Results:The time of first ambulation and the length of hospital stay in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of tumor necrosis factor-αand C-reactive protein between the two groups(P>0.05).After 1 week of treatment,the levels of tumor necrosis factor-αand C-reactive protein in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The total treatment satisfaction in the observation group was higher than that in the control group,and the difference was statistically significant(P=0.043).Conclusion:ERCP combined with peritoneal catheter drainage has good effect in treatment of biliary leakage after hepatobiliary surgery,can shorten the time of ambulation and the length of hospital stay,accelerate the regression of inflammatory response,and improve the treatment satisfaction.