摘要
目的 探讨内镜治疗手术后并发胆漏和继发胆管狭窄的方法及效果。方法 胆漏患 者均先行内镜下十二指肠乳头切开,行鼻胆管引流术,继续保留原有胆道、腹腔引流。待胆道、腹腔引 流停止1-2周证实胆漏愈合后拔管,伴有胆道狭窄的患者在拔除鼻胆引流管后置入塑料内支架,持 续扩张2-3个月。结果 22例胆漏患者鼻胆引流3-4周后胆漏处均闭合,13例胆管狭窄置入内支 架者,10例支架取出后狭窄解除,2例合并肝总管狭窄者经重新置入双支架3个月后效果良好,1例 左肝管狭窄伴结石者,再置入单支架,术后仍有胆道感染症状反复出现。结论 内镜治疗可列为手术 后胆漏或继发胆管狭窄治疗的首选方法。
Objective To explore for the effect of endoscopic treatment on biliary leakage and biliary duct stricture. Methods All patients with biliary leakage and biliary duct stricture were treated by endo scopic sphincoterotomy and endoscopic nasobiliary drainage ( ENBD) during abdominal cavity drainage. EN-BD was removed when biliary leakage healed and abdominal cavity drainage ceased for 1-2 weeks were confirmed. Plastic stents were implanted to distend the biliary duct stricture for 2-3 months. Results Twenty two patients with biliary leakage were cured 3-4 weeks after ENBD. Ten out of 13 patients implanted with plastic stent were recovered uneventfully after stent removed, and 2 patients also recovered after installation of double-stents for 3 months, while another case with calculus and stricture of left hepatic duct in spite of implantation of simple-stent suffered repeatedly from biliary tract infection. Conclusions Endoscopic therapy is the first choice in treating biliary leakage or secondary biliary duct stricture.
出处
《中华消化内镜杂志》
2005年第1期13-15,共3页
Chinese Journal of Digestive Endoscopy
关键词
内镜治疗
术后
胆漏
继发胆管狭窄
Postoperative complications
Biliary leakage
Bile duct stricture
Endoscopic therapy
