急性重症胆管炎；腹腔镜；微创外科；治疗_

急诊腹腔镜治疗老年人重症胆管炎38例临床分析

http://www.100md.com 《腹腔镜外科杂志》 2006年第6期

急性重症胆管炎；腹腔镜；微创外科；治疗,,急性重症胆管炎；腹腔镜；微创外科；治疗,1资料与方法,2结果,3讨论,参考文献：

     【摘要】目的：探讨老年急性重症胆管炎(ASCT)的急诊腹腔镜治疗可行性。方法：回顾2001～2004年本院收治的38例老年重症胆管炎的临床资料，对其临床表现、治疗及预后进行分析探讨。结果：38例均获成功。内镜及腹腔镜术治疗无严重并发症，围手术期死亡2例，死亡率52%。手术时间为60～189min(平均985min)，住院天数12～18d(平均123d)，术中出血50～400ml(平均958ml)。结论：ASCT病人应行急诊微创腹腔镜手术治疗，手术越早效果越好，以微创手术为主的综合治疗是降低ACST病死率的有效措施。延误手术时机、高龄、合并症是死亡的主要原因。

    【关键词】急性重症胆管炎；腹腔镜；微创外科；治疗

    Clinical analysis acute laparoscopic therapy of 38 aged patients with acute severe cholangitis

    CHEN Kaiyun,XIANG Guoan,WANG Hanning,et al.

    Department of General Surgery,the Second people’s Hospital Guangdong province,Guangzhou 510317,China)

    【Abstract】 Object:To explore the feasibility of acute laparoscopic treatment in aged patients with acute cholangitis.Methods:The clinical data of 38 patients with acute severe cholangitis(ASCT)treated in our hospital from 2001 to 2004 were retrospetively analyzed.Results:All the 38 patients were successfully accepted acute laparoscopic treatment.No severe complication happened.There were 2 cases died during periopration,the mortality were 5.2%.The operative times,operative blood loss,and hospital stay were60～189 min(average 98.5min),50～400ml(average 95.8ml),12～18days(12.3d).Conclusions:The patients with ACST should be treated by minimally invasive laparoscope as soon as possible.Comprehensive treatment dominated by minimally invasive laparoscope is the effective measurement for declining mortality.Delayed operation,old age and complications are the main causes of death for the patients with cute severe cholangitis. ......

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