摘要
目的探讨经皮肾镜下治疗胆总管探查取石术后并发腹膜后脓肿的临床疗效。方法采用回顾性描述性研究方法。收集2004年1月至2018年12月武警新疆总队医院收治的13例胆总管探查取石术后并发腹膜后脓肿患者的临床资料;男5例,女8例;平均年龄为57岁,年龄范围为34~81岁。13例患者均采用经皮肾镜下腹膜后脓肿清创引流术。观察指标:(1)手术及术后情况。(2)随访情况。采用门诊或电话方式进行随访,了解患者术后胆总管结石复发情况。随访时间截至2019年9月。偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。结果(1)手术及术后情况:13例患者均顺利完成经皮肾镜下腹膜后脓肿清创引流术,未发现肾脏、胰腺、血管、腹膜等损伤。13例患者中,术中放置1根引流管11例,放置2根引流管2例。13例患者手术时间为41 min(24~77 min),术中抽取脓液量为241 mL(110~640 mL),术后体温恢复正常时间为1.5 d(1.0~4.0 d)。13例患者术后引流管放置时间为42 d(5~94 d),其中2例右髂区引流管放置时间分别为5 d和11 d,11例后腰部引流管放置时间为23~94 d;术后住院时间为42 d(26~67 d)。13例患者术后胸腔积液渐消失,均治愈出院。(2)随访情况:13例患者均获得术后随访,随访时间为6~48个月,中位随访时间为18个月,均无胆总管结石复发。结论经皮肾镜下治疗胆总管探查取石术后并发腹膜后脓肿安全、有效。
Objective To investigate the clinical efficacy of percutaneous nephroscopy in the treatment of retroperitioneal abscess after common bile duct exploration.Methods The retrospective and descriptive study was conducted.The clinical data of 13 patients with retroperitioneal abscess after common bile duct exploration who were admitted to Xinjiang Autonomous Region Hospital of Chinese People′s Armed Forces between January 2004 and December 2018 were collected.There were 5 males and 8 females,aged from 34 to 81 years,with an average age of 57 years.All the 13 patients underwent debridement and drainage for retroperitioneal abscess under percutaneous nephroscope.Observation indicators:(1)surgical and postoperative situations;(2)follow⁃up.Follow⁃up was performed using outpatient examination and telephone interview to detect postoperative choledocholithiasis recurrence up to September 2019.Measurement data with skewed distribution were represented as M(range).Count data were described as absolute numbers.Results(1)Surgical and postoperative situations:all the 13 patients underwent successfully debridement and drainage for retroperitioneal abscess under percutaneous nephroscope,without kidney injury,pancreatic damage,vascular injury or peritoneal damage.There were 11 cases with 1 drainage tube,and 2 cases with 2 drainage tubes.The operation time,volume of intraoperative pus extracted,time to body temperature resuming to normal of 13 patients were 41 minutes(range,24-77 minutes),241 mL(range,110-640 mL),1.5 days(range,1.0-4.0 days),respectively.The time to postoperative removal of drainage tube of 13 patients was 42 days(range,5-94 days),in which the time to postoperative removal of drainage tube at right iliac region was 5 days and 11 days in 2 patients,and at lower back was 23- 94 days in 11 patients, respectively. Duration of postoperative hospital stay was 42 days ( range, 26 - 67 days). All the 13 patients had pleural effusion disappeared, and were cured and discharged. (2) Follow⁃up: 13 patients were followed up for 6 - 48 months, with a median time of 18 months. No recurrence occurred. Conclusion The treatment with percutaneous nephroscopy is safe and effective for retroperitioneal abscess after common bile duct exploration.
作者
张志刚
焦辉
庄仕华
李健
陆海琴
王佐
王静
黄苏溪
Zhang Zhigang;Jiao Hui;Zhuang Shihua;Li Jian;Lu Haiqin;Wang Zuo;Wang Jing;Huang Suxi(Department of Hepatobiliary Surgery,Xinjiang Autonomous Region Hospital,Chinese People′s Armed Forces,Urumqi 830091,China;Department of Urology,Xinjiang Autonomous Region Hospital,Chinese People′s Armed Forces,Urumqi 830091,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2019年第12期1158-1162,共5页
Chinese Journal of Digestive Surgery
关键词
腹膜后脓肿
肝胆管结石病
经皮肾镜
胆总管探查
手术后并发症
治疗
Retroperitioneal abscess
Hepatolithiasis
Percutaneous nephroscope
Common bile duct exploration
Postoperative complications
Treatment
作者简介
通信作者:焦辉,Email:jhuijhui2014@163.com。
