目的评价胆道镜和十二指肠镜在治疗T管拔除后胆瘘中的应用价值。方法对我院2000年5月至2004年12月期间9例采用胆道镜或十二指肠镜下鼻胆管引流(ENBD)治疗T管拔除后胆瘘患者的资料进行回顾性分析。结果本组病例采用胆道镜和十二指肠镜治疗均获成功,无并发症。结论胆道镜和十二指肠镜治疗T管拔除后胆瘘临床疗效可靠,有推广价值。
Objective To investigate the curative effect of peritoneal drainage tube fixation with titanium clamp in 210 patients during laparoscopic operations. Methods The clinical data of 210 patients with peritoneal drainage fixation via titanium clamp during laparoscopic operations in this hospital were analyzed retrospectively. Results In 210 patients, drainage tube placement lasted for 5-20 d with an average of 8.5 d. No complications such as drainage tube drifting, position changing or obstructed drainage occurred, and all the patients were successfully extubated. Conclusion During laparoscopic operations, the method that drainage tube fixed with titanium clamp is simple with reliable drainage results, affirmed curative efficacy and obviously decreased operative complications, which is worthy of clinical practice and generalization.
Objective To summarize the treatment experience for concomitant diseases of other abdominal organs in laparoscopic cholecystectomy (LC). Methods The clinical data of 176 patients with LC and concomitant diseases of other abdominal organs were analyzed retrospectively, including preoperatively diagnosed cases (such as 53 with liver cyst, 15 with choledocholithiasis, 7 with chronic appendicitis, 5 with inguinal hernia, 4 with renal cyst, and 6 with ovarian cyst) and intraoperatively diagnosed cases (such as 72 with abdominal cavity adhesion, 4 with internal fistula between gallbladder and digestive tract, 3 with Mirizzi syndrome, and 7 with unsuspected gallbladder carcinoma). Results All the operation were successfully completed in 176 patients without severe complications, including 53 cases treated with LC plus fenestration of hepatic cyst, 15 with choledocholithotomy, 7 with appendectomy, 5 with tension free hernia repair, 4 with renal cyst fenestration, 6 with oophorocystectomy, 72 with adhesiolysis, 3 with fistula resection plus intestine neoplasty, 2 with intraoperative cholangiography plus choledocholithotomy, 5 with LC plus gallbladder bed complete burning, and 4 cases treated with conversion to open surgery (1 with intestinal fistula repair, 1 with choledocholithotomy, and 2 with radical resection for gallbladder carcinoma). Conclusions It is safe and effective to treat gallbladder diseases complicated with other concomitant diseases simultaneously with laparoscopic operation, if the principles of surgical operation are followed and the indications and applicable conditions are strictly followed. And conversion to open surgery is necessary.