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临床效果

EClinical Effect of Retrograde Endoscopic Cholangiopancreatography Combined with Peritoneal Catheter Drainage in the Treatment of Bile 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2020年1月—2023年2月贵州省贵州医科大学附属肿瘤医院肝胆外科手术治疗的肝胆手术后胆漏患者48例作为研究组,另外选取2017年1月—2019年2月接受手术治疗的同类型患者24例作为对照组。对照组行腹腔置管引流术治疗,研究组在对照组基础上联合ERCP治疗。比较两组治疗效果及手术前后的肝功能情况、并发症发生率。结果:研究组治疗有效率高于对照组,差异有统计学意义(P<0.001);术后,研究组谷丙转氨酶、谷草转氨酶和总胆红素水平均低于对照组,差异有统计学意义(P<0.001);研究组并发症发生率低于对照组,差异有统计学意义(P<0.001)。结论:ERCP联合腹腔置管引流治疗肝胆手术后胆漏的临床效果优良,术后无治疗失败案例,可改善患者肝功能指标,降低并发症发生率,可为临床治疗肝胆手术后胆漏患者提供参考。

Objective:To analyze the clinical effect of retrograde endoscopic cholangiopancreatography(ERCP)combined with peritoneal catheter drainage in the treatment of bile leakage after hepatobiliary surgery.Methods:A total of forty-eight patients with bile leakage after hepatobiliary surgery treated by hepatobiliary surgery in Guizhou Province Affiliated Cancer Hospital of Guizhou Medical University from January 2020 to February 2023 were selected as the study group,and another twenty-four patients of the same type who received surgical treatment from January 2017 to February 2019 were selected as the control group.The control group was treated with peritoneal drainage,and the study group was treated with ERCP on the basis of the control group.The therapeutic effect,liver function and complication rate before and after operation were compared between the two groups.Results:The effective rate of the study group was higher than that of the control group,the difference was statistically significant(P<0.001);After operation,the levels of alanine aminotransferase,aspartate aminotransferase and total bilirubin in the study group were lower than those in the control group,the difference was statistically significant(P<0.001);The complication rate of the study group was lower than that of the control group,and the difference was statistically significant(P<0.001).Conclusion:ERCP combined with peritoneal catheter drainage has good clinical effect in the treatment of bile leakage after hepatobiliary surgery,and there are no cases of postoperative treatment failure,which can improve the liver function index of patients and reduce the incidence of complications,and can provide a reference for the clinical treatment of patients with biliary leakage after hepatobiliary surgery.