Vol・32No.1Jan・2012•怡著•上悔交通大学学报(医学版)JouvrwlofSlianglmiJiautongUnivemit)(MedicalScience)[文章编号]1674*115(2012)01・OO93・O3十二指肠镜与传统治疗对胆囊切除术后胆痿疗效的比较分析楼晓楼，杨建军，刘文勇，顾岩(上悔交通大学医学枝附皿第九人民浜院普外科，上降200011)［摘要】4*比较传统洽貯与十二折肠镜诊治胆囊切除术后艇痿的效果。方K35切賦术后胆矮恵杆分为十二热肠镜组(采用十二指肠饱下逆行胆離管造彫技术诊治胆煤・“二17)和传统治疗纽(采用保守治疗和孑术治疗胆瘻・“=18),比牧购俎駅建部位明确比例、秋姥治倉时间、冉次手术比例利并发症发生承。H«十二指肠檢爼紀递部位《H呦比例9着商于传统洽疗纽(76.47%和38.89%,P<0.05),ffi«治愈时间显莒短于传统沟疗组［(13±3)d和(23±5)d.P<0.05］,冉次手术比例显著低丁传统治疗组(II.76編和3&89強・r<0.05),并发症发生率显芳低于传统诒疗组(17.65%和38.89*,P<0.05)o*论与传统治疗相比•十二捋肠诡诊治駁勢切除术后胆瘪具有做创、安全、疗效确切轸优点。［关键词］胆貨切除术：關變；内镜［1)01］10.3969/j.i^n.1674-8115.2012.01.019［中图分类号JR575.6；R657.4［文献标志码］AContrastanalysisofduodenoscopictreatmentandtraditionaltreatmentforbileleakageaftercholecystectomyl.OUXiao-lou・YANGJian-jun,LIUWen-yong.GUYan(DepnrlmentofGeneralSurgery^theNinthPeopledHospitalShanghaiJiaotongl/nit^rsitySchtwlofMedicine.Shanghai2000Chirm)|Abstract]ObjectiveTotrompart*theeffectsofduodenoscopictreatmentandtraditionaltrealmcnlonbileleakageaftercholecyMeclorny*MethodsThirty-fivepatientswilhBileleakageaftercholrcystwtomyHeredividedintoduodenoscopictreatmentgn)up(managedwithendoscopicretrograiiecholangiopancreatographynwthod.n=17)andtradilionaitrealmentgrouj)(managedwithconscnalivetherapyandsurgery,/>=18)•Tlicpercentagesofbilelrakdgelocalionconfinnaliorhtimeofbileleakageclosure^re-operationratesandprevalencesofcomplicationswerecomparedbetweentwogroups.ResultsThepercentageofbilelrakugclocationconfirmationinduodenoscopictreatmentgroupwa»signiGcantlyhigherthanthatintraditionaltreatmentgroup(76.47%rs3&89%tP<0.05)♦thrtimeofbileleakageclosureinduodenoscopictreatmentgroupwassignificantlyshorterthanthatintraditionaltreatmentgroup[(13士3)d(23±5)<i.P<0<051,(heoperationrateinduodenoscopictreatmentgroupwassignificantlylowerthanthatintraditionaltreatmentgroup(11.76%w38.89%.P<0.()5)•andlheprevalenceofcomplicationsinduodenoscopicIrvatmentgroupwassigniGcantlylowerthanthatintraditionaltreatmentgroup(I7<65%rs38.89%,P<0・05)・ConclusionComparedwithtraditionaltreatmentsduodenoscopictreatmentforbileleakageaftercholecystectomyisle»sinva»ivewmoresafeandmoreeffective.(Keywords)cholecyHlectomy;bileleakage;endowope胆碘切除术后易突发胆痿•肥痿的部位和发生原囚多不明确，处理棘手。1990年I月一2008年6月，我们釆用传统治疗方法或十二指肠镜技术诊治胆囊切除术后脚•痿虑若，现对其疔效进行对比分析。1对象与方法1-1对象1990年1月一2008年6月上海交通大学医学院附属第九人民医院泮外科收治胖程切除术后胆矮患者35例，患者分别于本院或他院实施胆曩切除术。根据胆瘻治疗方法•患者分为传统治疗组(«=18)和十二指肠镜组(n=H)O传统治疗组中，男性B例,女性10例；平均年龄48.8岁；其中腹埠镜胆掘切除术荷胆痿和开腹胆囊切除术后胆痿各9例“十二指肠镜组中•男性7例•女性10例；平均年龄50.6岁；梵中35腔镜胆囊切除术后胆痿9例，开腹胆麋切除术后胆瘙8例。12胆播的表现和诊断35例患者中，6例胆囊切除术后I~2d出现急性胆汁性腹朕炎，腹腔引流恃侮日胆汁引漁试为500mL；26例术后1~3<1腹腔引流管每日胆汁引洗凤>5()ml・,其中8例无明显收稱、腹胀等不适表现;3例术后2-5"突发职痛、腹胀等症状，B超检査见...