上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (1): 93-.doi: 10.3969/j.issn.1674-8115.2012.01.019

• 论著（临床研究） • 上一篇    下一篇

十二指肠镜与传统治疗对胆囊切除术后胆瘘疗效的比较分析

楼晓楼, 杨建军, 刘文勇, 顾 岩   

  1. 上海交通大学 医学院附属第九人民医院普外科, 上海 200011
  • 出版日期:2012-01-28 发布日期:2012-01-29
  • 作者简介:楼晓楼（1966—）, 男, 副主任医师, 硕士；电子信箱: lou_xl@163.com。

Contrast analysis of duodenoscopic treatment and traditional treatment for bile leakage after cholecystectomy

LOU Xiao-lou, YANG Jian-jun, LIU Wen-yong, GU Yan   

  1. Department of General Surgery, the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2012-01-28 Published:2012-01-29

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摘要：

目的 比较传统治疗与十二指肠镜诊治胆囊切除术后胆瘘的效果。方法 35例胆囊切除术后胆瘘患者分为十二指肠镜组(采用十二指肠镜下逆行胆胰管造影技术诊治胆瘘，n=17)和传统治疗组(采用保守治疗和手术治疗胆瘘，n=18)，比较两组胆瘘部位明确比例、胆瘘治愈时间、再次手术比例和并发症发生率。结果 十二指肠镜组胆瘘部位明确比例显著高于传统治疗组（76.47%和38.89%, P<0.05），胆瘘治愈时间显著短于传统治疗组[(13±3) d和(23±5) d, P<0.05]，再次手术比例显著低于传统治疗组（11.76%和38.89%, P<0.05），并发症发生率显著低于传统治疗组（17.65%和38.89%, P<0.05）。结论 与传统治疗相比，十二指肠镜诊治胆囊切除术后胆瘘具有微创、安全、疗效确切等优点。

关键词: 胆囊切除术, 胆瘘, 内镜

Abstract:

Objective To compare the effects of duodenoscopic treatment and traditional treatment on bile leakage after cholecystectomy. Methods Thirty-five patients with bile leakage after cholecystectomy were divided into duodenoscopic treatment group (managed with endoscopic retrograde cholangiopancreatography method, n=17) and traditional treatment group (managed with conservative therapy and surgery, n=18). The percentages of bile leakage location confirmation, time of bile leakage closure, re-operation rates and prevalences of complications were compared between two groups. Results The percentage of bile leakage location confirmation in duodenoscopic treatment group was significantly higher than that in traditional treatment group (76.47% vs 38.89%, P<0.05), the time of bile leakage closure in duodenoscopic treatment group was significantly shorter than that in traditional treatment group [(13±3) d vs (23±5) d, P<0.05], the re-operation rate in duodenoscopic treatment group was significantly lower than that in traditional treatment group (11.76% vs 38.89%, P<0.05), and the prevalence of complications in duodenoscopic treatment group was significantly lower than that in traditional treatment group (17.65% vs 38.89%, P<0.05). Conclusion Compared with traditional treatment, duodenoscopic treatment for bile leakage after cholecystectomy is less invasive, more safe and more effective.

Key words: cholecystectomy, bile leakage, endoscope