Objective To explore the diameter change of the extrahepatic bile duct before and after laparoscopic cholecystectomy (LC). Methods From Jan. 2006 to Dec. 2007， 113 patients including chronic gallstone cholecystitis （n=55）, inactive cholecystolithiasis （n=46） and gallbladder polyps （n=12） were collected and treated by LC. The diameters of their extrahepatic bile ducts were measured by B ultrasonography before operation， 3 months and 6 months after operation. These data were collected and analyzed retrospectively. Results The diameters of the extrahepatic bile ducts of all patients before LC， 3 months and 6 months after LC were (5±2) mm, (8±2) mm and (6±2) mm respectively. And in chronic gallstone cholecystitis patients they were (5±2) mm, (9±2) mm and (6±2) mm respectively， in inactive gallstone cholelithiasis patients they were (5±2) mm, (8±2) mm and (6±2) mm respectively， and in gallbladder polyps ones they were (5±2) mm, (7±2) mm and (5±2) mm respectively. Conclusion The change of the extrahepatic bile duct diameter after LC is a dynamic process. It is enlarged on the third month after operation than before operation. In the sixth month after operation marked retraction occurs, and compared with before operation, it shows no obvious statistic significance.
【摘要】目的 探讨急性重症胆管炎(ASC)患者的手术时机、治疗方式的选择以及患者围手术期的治疗。方法 回顾性分析156例ASC患者的临床资料。结果 治愈131例，死亡25例，总死亡率为16.0%。入院后行急诊手术者32例，术后死亡9例，死亡率28.1%； 入院后经支持治疗、纠正休克和酸碱失衡及抗感染治疗后再行手术者53例，死亡9例，死亡率为17.0%。行ERCP+乳头括约肌切开术治疗17例,行PTCD 治疗12例,行保守治疗42例。结论 对ASC患者掌握好手术时机，根据病情选择治疗方式，重视围手术期支持治疗以及适时手术治疗，是降低死亡率，提高疗效的重要措施。