【摘要】 目的探讨胆道镜探查所致腹壁窦道相关并发症的发生及其处理。方法回顾性分析2013年1-12月遂宁市中心医院肝胆科和川北医学院附属医院普外科行胆道镜探查发生腹壁窦道并发症的74例(76例次)病人临床资料。结果 74例中,引流管意外脱出55例,窦道破裂7例,窦道出血3例,窦道小肠瘘4例,结石窦道内嵌顿1例,窦道严重迂曲3例,窦道与下段胆管成角过小4例。76例次中,56例次经过处理后恢复完整窦道,并最终完成胆道镜探查和治疗;20例次因窦道相关并发症导致治疗中断。有1例次因并发症而再次手术探查。结论腹壁窦道相关并发症是导致胆道探查术后胆道镜取石治疗中断的重要原因,通过一定处理可使部分病人窦道恢复,保障取石治疗的顺利完成,但预防重于处理。更多还原

【Abstract】 ObjectiveTo explore complications and treatment of abdominal sinus-tract for choledochoscopicexploration.MethodsThe clinical data of 74 cases who have sinus-tract complications 76 times from January 2013 toDecember 2013 in Department of Hepatobiliary Surgery, Affiliated Suining Central Hospital of North Sichuan MedicalCollege and Department of General Surgery, Affiliated Hospital of North Sichuan Medical College were analyzedretrospectively.ResultsAmong 74 cases, there were 55 cases who’s drainage were displaced by accident. Sinus-tractruptured in 7 cases. Massive hamorrhage from sinus-tract occurred in 3 cases. Sinus-intestine fistula occurred in 4cases. Stone was incarcerated in sinus-tract in 1 case. Sinus-tract was obviously tortuous in 3 cases. The angle betweensinus-tract and lower bile tube was too small in 4 cases. Among 76 times, 56 times of sinus-tract were retained. Thosepatients had finished choledochoscopic exploration and stones extraction. A total of 20 times of sinus-tract had occlusionbecause of sinus related complication and the operation of choledochoscopic treatment was failed. One case wasperformed laparotomy due to bile peritonitis.ConclusionAbdominal sinus-tract related complications are importantreasons which would cause interruption of postoperative choledochoscopy for biliary stone extraction. Certain procedurescould take to retain sinus-tract and to complete cholelithiasis treatment. But,prevention is more important thantreatment.更多还原