CAJ | 학술논문

目的探讨不同术式在治疗急性梗阻性化脓性胆管炎的疗效.方法回顾分析2005年1月至2010年12月42例急性梗阻性化脓性胆管炎患者的临床资料.全部病例分成急诊外科手术组(15例)和分期手术组(27例),急诊外科手术组接受传统外科手术,分期手术组接受ERCP+EST+LC,ERCP+EST+ENBD+外科手术和经皮肝穿刺胆道引流术(PTCD)+外科手术.结果急诊外科手术组15例均接受传统外科手术.分期手术组27例中,ERCP+EST 19例,其中,二期LC10例;ERCP+EST+ENBD+外科手术5例;经皮肝穿刺胆道引流术(PTCD)+外科手术3例.急诊手术的并发症较分期手术多.急诊手术和分期手术各死亡1例.结论急性梗阻性化脓性胆管炎的手术治疗宜采用简单、有效的分期手术.早期解除梗阻、充分引流是治疗的关键,待患者渡过危险期后,再择期手术,完成彻底的治疗.
목적 탐토불동술식재치료급성경조성화농성담관염적료효.방법 회고분석2005년1월지2010년12월42례급성경조성화농성담관염환자적림상자료.전부병례분성급진외과수술조(15례)화분기수술조(27례),급진외과수술조접수전통외과수술,분기수술조접수ERCP+EST+LC,ERCP+EST+ENBD+외과수술화경피간천자담도인류술(PTCD)+외과수술.결과 급진외과수술조15례균접수전통외과수술.분기수술조27례중,ERCP+EST 19례,기중,이기LC10례;ERCP+EST+ENBD+외과수술5례;경피간천자담도인류술(PTCD)+외과수술3례.급진수술적병발증교분기수술다.급진수술화분기수술각사망1례.결론 급성경조성화농성담관염적수술치료의채용간단、유효적분기수술.조기해제경조、충분인류시치료적관건,대환자도과위험기후,재택기수술,완성철저적치료.
Objective To discuss the effectivenes of different operation on patients with acute obstructive supputative cholangitis(AOSC). Methods The clinical data of 42 patients with AOSC from January 2005 to December 2010 were collected and analyzed retrospectively. All patients were divided into the emergency surgery group(15 cases)and the surgery by stages group(27 cases ). The emergency surgery group were treated by traditional emergency operation .The surgery by stages group were treated by Endoscopic Retrograde Cholangio Canereatography(ERCP)+Endoscopic Sphincterotomy( EST )+Laparosopy (LC), ERCP +EST+ endoscopic nasobiliary drainage(ENBD)+surgery operation, and percutaneous transhepatie cholangio drainage (PTCD). Results The emergency surgery group ( 15 cases ) were operated by emergency surgery, the surgery by stages group( 27 cases ) were operated by stages. Among 27cases, 19 cases were used ERCP +EST+ ENBD, 10 cases LC among 19 cases.5 cases ERCP +EST+ENBD+operation.3 cases PTCD. Complications of emergency surgery group is more than surgery by stages group. Emergency surgery group and surgery by stages group died each 1 patient. Conclusions Treatment on patients with AOSC would choose simple and effectual operation by stages. Disengaging the obstruction earlier and drainaging enough the biliary tract are the key points in treatment. To select again operative time and complete exhaustiveced operation waiting for patient ferry crises.