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胆管炎

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Objective To study the clinical features and treatment of biliary stone with acute cholangitis.

目的 探讨胆道结石并急性胆管炎的临床表现和治疗。

R: Fever, jaundice and abdominal pain consist of Charcot triad which is feature of cholangitis.

住院医师:发热,黄疸和腹痛是Charcot 三联症,这是胆管炎的特征。

Objective:To investigate the diagnosis and treatment of refluxing cholangitis.

目的探讨反流性胆管炎的诊断和治疗方法。

Objective To improve the effect of surgical treatment of acute severe cholangitis.

目的 探讨提高急性重症胆管炎外科治疗效果的方法。

Results Internal jaundice was found in 63 cases (acute hepatitis in 40 cases, chronic hepatitis in 4 cases ,cirrhosis with ascites in 7cases ,cirrhosis with hepatic cancer in 4 cases, acute bacterial cholangitis in 1 case and acute calculous cholecystitis in 7 cases). Surgery jaundice in 21 cases (common bile duct stone in 9 cases, cholangiocarcinoma in 3 cases, pancreatic head cancer in 4 cases, focal pancreatitis in 1 case, ampullar carcinoma in 2 cases and biliary duct distal obstruction in 2 cases).

结果:内科性黄疸63例(急性肝炎40例,慢性肝炎4例,肝硬化伴腹水7例,肝硬化伴肝癌4例,急性细菌性胆管炎1例,急性结石性胆囊炎7例),外科性黄疸21例(胆总管结石9例,胆管癌3例,胰头癌4例,胰头炎症1例,壶腹癌2例,胆总管末端梗阻性病变2例)。

Results All patients underwent percutaneous cholecystostomy with technical success without major periprocedural complications. 93 (96%) patients responded well clinically showing disappearance of right upper abdomen pain and fevers within 72hr. 4 patients complicated with common bile duct stones were underwent PTCD one day after the procedure because of no response clinically. After PTCD, all 4 patients attained clinical symptom relief within 72hr.

结果 所有97例患者均一次置管成功,无任何并发症。93例(96%)患者临床体征如右上腹疼痛、发热在72h内缓解;同时,血常规中的WBC及中性粒细胞均于72h内降至正常范围。4例患者由于肝总管内结石合并胆管炎临床症状缓解不明显而于第2天行经皮肝穿胆管引流术,术后临床症状于72h内亦缓解。

PSC is a kind of rare and unknown disease due to stenosis cholangitis.Its main symptoms is diffuse fibrotic incrassation and duct stenosis in intrahepatic and extrahepatic bile duct system..

原发性硬化性胆管炎( primary sclerosing cholangitis,PSC )是一种少见的、原因未明的胆管炎症性狭窄性疾病。

Result Reoperative reasons include unresected cysts canceraztion (3 cases);unresected cysts calculogenesis (4 cases);anastomotic stoma between gut and cyst or bile duct stenosis (6 cases);reflux cholangitis(1 case);recurrence cholecystitis (6 cases).

结果再次手术的原因是囊肿切除发生癌变3例;囊肿未切除形成结石4例;囊肿或胆管与肠道吻合口狭窄6例;返流性胆管炎1例;未切除胆囊及复发性胆囊炎6例。

There is no unanimous cause for primary sclerosing cholangitis. The bile duct lesions vary due to various causes.

原发性硬化性胆管炎的病因不是单一的,不同原因所致的胆管病变可能有差别。

Primary sclerosing cholangitis , an inflammatory disease of the bile duct, autoimmune in nature.

原发性硬化性胆管炎,胆管发炎的疾病,免疫性的性质。

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