[1]陈焕伟,崔伟珍①,王军华,等.超声引导下经皮经肝胆囊/胆管置管引流术在肝胆系疾病中的临床应用[J].中国微创外科杂志,2005,05(4):292-294.
　Chen Huanwei*,Cui Weizhen,Wang Junhua*,et al.Ultrasound-guided percutaneous transhepatic gallbladder or bile duct drainage in hepatobiliary diseases[J].Chinese Journal of Minimally Invasive Surgery,2005,05(4):292-294.
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超声引导下经皮经肝胆囊/胆管置管引流术在肝胆系疾病中的临床应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
05
期数:
2005年4期
页码:
292-294
栏目:
出版日期:
2005-04-30

文章信息/Info

Title:
Ultrasound-guided percutaneous transhepatic gallbladder or bile duct drainage in hepatobiliary diseases
作者:
陈焕伟; 崔伟珍①; 王军华; 甄作均　
广东省佛山市第一人民医院肝胆外科,佛山,528000
Author(s):
Chen Huanwei*; Cui Weizhen;  Wang Junhua*;  et al.
Department of Hepatobiliary Surgery, Foshan First People’s Hospital, Foshan 528000, China
关键词:
介入超声;  PTGD/PTBD;  肝胆疾病
Keywords:
Interventional ultrasound; 　PTGD /PTBD; 　Hepatobiliary disease
分类号:
R657.4
文献标志码:
A
摘要:
目的探讨超声引导下经皮经肝胆囊置管引流术(percutaneous transhepatic gallbladder drainage,PTGD)/经皮经肝胆管置管引流术(percutaneous transhepatic bile duct drainage,PTBD)在肝胆系疾病中的应用价值. 方法从2000年12月至2003年12月在超声引导下对60例患者施行PTGD/PTBD 68例次,其中急性化脓性胆囊炎15例,急性重症胆管炎8例,各种恶性梗阻性黄疸37例. 结果 15例急性化脓性胆囊炎患者行PTGD术,14例成功,1例失败而中转手术.37例恶性梗阻性黄疸患者共行45例次PTBD术,42次置管成功,3例失败,其中2例中转手术,1例放弃治疗;14例择期行胆管癌切除术或姑息内引流术,8例在X线透视下放置胆道支撑架,15例患者长期带管,最长存活者已超过2年,平均9个月.8例急性重症胆管炎6例成功,1例因引流不畅而中转手术,1例死于多器官功能衰竭.并发症包括:胆漏2例,出血3例,门静脉胆管瘘1例,引流管脱出或阻塞7例. 结论超声引导下PTGD/PTBD是胆道引流的有效方法,具有创伤小,操作简便、准确、安全,并发症少等优点,在肝胆系疾病,尤其是急性胆囊炎具有较大的临床应用价值.
Abstract:
Objective　To investigate the practicalvalue ofultrasound-guided percutaneous transhepatic gallbladderdrainage (PTGD) and percutaneous transhepatic bile ductdrainage (PTBD) in the treatment of hepatobiliary diseases.　M ethods　A total of 68 times ofultrasound-guided PTGD /PTBD were performed in 60 patients from December2000 toDecember2003, including15 cases of acute pyogenic cholecystitis, 8 cases of acute severe cholangitis and 37 cases ofmalignant obstructive jaundice.　Results　Out of the 15 cases of acute pyogenic cholecystitis, PTGD was completed successfully in 14 cases and failed in 1 casewhich then required a conversion to open operation. The 37 cases ofmalignant obstructive jaundice had undergone 45 times ofPTBD, which consisted of42 times of successful drainage tube placement and 3 times of failure (2 cases of conversions to open operation and 1 case of quitting treatment). Out of the 37 cases, resection ofbile duct carcinoma orpalliative cholangiojejunostomywas conducted in 14 cases, stents were inserted into the bile ducts under radioscopy in 8 cases, and the drainage tubeswere left in place permanently in 15 cases ( the maximum survival time was over 2 years and the mean survival time was 9 months). Of the 8 cases of acute severe cholangitis, successful drainagewas achieved in 6 cases, a conversion to open surgerywas required in 1 case because of blocked drainage, and 1 patientdied of themultiple organ failure (MOF). Complications included 2 cases of bile leakage, 3 cases of hemorrhage, 1 case of portal vein-bile duct fistula, and 7 cases ofdrainage tube dislocation orblockage.　Conclusions　Ultrasound-guided PTGD /PTBD is an effective alternative for bile duct drainage, with advantages ofminimal invasion, simplicity and accurateness of performance, safety and fewer complications. Itpresentsmuch clinical value for hepatobiliary diseases, especially acute cholecystitis.

参考文献/References:

[1]吕明德,董宝玮. 临床腹部超声诊断与介入超声学.广州:科技出版社,2001.278. [1]吕明德,董宝玮. 临床腹部超声诊断与介入超声学.广州:科技出版社,2001.278.
[2]Kim KH, Sung CK,Park BK,et al. Percutaneous gallbladder drainage for delayed laparoscopic cholecystectomy in patients with acute cholecystitis. Am J Surg,2000,179(2):111-113.
[3]郑兴学,王冰,魏洪斌,等. 经皮经肝胆囊穿刺置管药物冲洗引流治疗老年急性化脓性胆囊炎. 中华肝胆外科杂志,2003,9(7):390-392.
[4]Shinchi H, Takao S, Nishida H,et al. Length and quality of survival following external be radiotherapy combined with expandable metallic stent unresectable hilar cholangiocarcinoma. J Surg Oncol,2000,75(2):89-94.
[5]Wong SK,Yu SC,Lam YH,et al. Percutaneous cholecystostomy and endoscopic cholecystolithotripsy in the management of acute cholecystitis.Surg Endosc,1999,13(1):48-52.

备注/Memo

备注/Memo:
基金项目：佛山市医学科研基金项目(No:2003233)①超声科
更新日期/Last Update: 2014-03-31