经皮肾镜治疗胆总管探查后腹膜后脓肿的临床疗效观察

Zhi-gang Zhang, H. Jiao, S. Zhuang, Jian Li, Hai-ming Lu, Zuoqian Wang, Jing Wang, Suxi Huang
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引用次数: 0

摘要

目的探讨经皮肾镜治疗胆总管探查术后腹膜后脓肿的临床疗效。方法采用回顾性和描述性研究。收集2004年1月至2018年12月在中国人民武装部队新疆自治区医院收治的13例胆总管探查术后腹膜后脓肿患者的临床资料。男5例,女8例,年龄34~81岁,平均57岁。13例患者均在经皮肾镜下对腹膜后脓肿进行清创引流。观察指标:(1)手术及术后情况;(2) 后续行动。截至2019年9月,通过门诊检查和电话访谈进行随访,以检测术后胆总管结石复发。具有偏斜分布的测量数据表示为M(范围)。计数数据被描述为绝对数。结果(1)手术及术后情况:13例患者均在经皮肾镜下成功清创引流腹膜后脓肿,无肾损伤、胰腺损伤、血管损伤或腹膜损伤。其中11例有1根引流管,2例有2根引流管。13例患者的手术时间、术中拔脓量、体温恢复正常时间分别为41分钟(24-77分钟)、241毫升(110-640毫升)、1.5天(1.0-4.0天)。13例患者术后拔除引流管的时间为42天(范围为5-94天),其中右髂区引流管的拔除时间分别为5天和11天,下背部引流管的拔出时间分别为23-94天。术后住院时间为42天(26-67天)。13例患者胸腔积液全部消失,治愈出院。(2) 随访:13例患者随访时间为6-48个月,中位随访时间为18个月。没有复发。结论经皮肾镜治疗胆总管探查术后腹膜后脓肿安全有效。关键词:腹膜后脓肿;肝结石;经皮肾镜;胆总管探查;术后并发症;治疗
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Clinical efficacy of percutaneous nephroscopy in the treatment of retroperitioneal abscess after common bile duct exploration
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. Key words: Retroperitioneal abscess; Hepatolithiasis; Percutaneous nephroscope; Common bile duct exploration; Postoperative complications; Treatment
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中华消化外科杂志
中华消化外科杂志 Medicine-Gastroenterology
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