残留结石性胆囊炎的诊断与手术治疗体会

DIAGNOSIS OF RESIDUAL CHOLECYSTITIS WITH GALLSTONES AND EXPERIENCES OF OPERATION(A REPORT OF 33 CASES)

目的 探讨残留结石性胆囊炎的原因、诊断及手术治疗的技术。方法 对 33例经手术证实的残留结石性胆囊炎的临床资料进行回顾性分析。结果 33例均经再次手术治愈。随访 3月～ 1 2年 ,效果优良率 :92 .86 %。结论 引起残留结石性胆囊炎的原因很多 ,最根本的就是未遵循辨—切—辨三字程序。其主要症状和体征与结石性胆囊炎相似 ,诊断上各项辅助检查的准确率不高 ,必须对各项检查进行综合性分析。治疗上必须遵循辨—切—辨三字程序 ,先切开胆总管、肝总管 。

Objective To investigate the reasons of residual cholecystitis with gallstones and the techniques of diagnosis and operation.Methods The clinical data of 33 cases of residual cholecystitis with gallstones which were identified by operation were retrospectively analyzed.Results All of the 33 cases were cured through reoperation.28 cases were followed up 3 months to 12 years and 92.86% of them showed good results.Conclusion A lot of causes resulted in residual cholecystitis with gallstones,the basic one was not following the progra, of identify cut identify.The symptoms and physical signs were analogy to cholecystitis with gallstones.The accurate rate of auxiliary examinations was not high,so the results of them should be analyzed comprehensivly.In the treatment the program of identify cut identify should be followed.The common bile duct and common hepatic duct should be opened first and then the residual gall be resected.