微创技术在急性梗阻性化脓性胆管炎治疗中的应用
Application of minimally invasive technique in the treatment of acute obstructive suppurative cholangitis
摘要急性梗阻性化脓性胆管炎(AOSC)是常见的外科急腹症之一,常因胆道梗阻引起胆道内压力增高从而引起各种临床症状,起病急,疾病进展快,是胆道良性疾病死亡的首要病因,及时的胆道减压和胆汁引流是治疗AOSC及挽救患者生命的关键。随着加速康复外科理念及微创技术手段的不断进步,内镜逆行胰胆管造影术、经皮经肝胆管穿刺引流术以及内镜超声引导下胆道引流术等微创技术手段逐渐成为治疗AOSC的首选治疗方式,在AOSC的治疗过程中发挥着越来越重要的作用。本文结合相关研究文献以及笔者在使用这些技术治疗AOSC过程中的一些个人体会,介绍了上述三种微创技术在治疗AOSC中的应用价值以及各项技术的优缺点,以为临床提供参考。
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abstractsAcute obstructive suppurative cholangitis (AOSC) is one of the common surgical acute abdomen. It often causes the increase of intrabiliary pressure due to biliary obstruction, resulting in various clinical symptoms. The onset is urgent and the disease progresses quickly. It is the primary cause of death of benign biliary diseases. Timely biliary decompression and bile drainage are the key to treat AOSC and save the lives of patients. With the continuous progress of the concept of enhanced recovery after surgery and minimally invasive technical means, minimally invasive technical means such as endoscopic retrograde cholangiopancreatography, ppercutaneous transhepatic catheterizde drainage and endoscopic ultrasound guided biliary drainage have gradually become the preferred treatment for AOSC, playing a more and more important role in the treatment of AOSC. Combined with relevant research literature and the author′s personal experience in the treatment of AOSC with these technologies, this paper introduces the application value, advantages and disadvantages of the above three minimally invasive technologies in the treatment of AOSC.
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