急性化脓性梗阻性胆管炎的损伤控制性外科治疗

【摘要】 目的 探讨损伤控制性外科（DCS）技术治疗急性梗阻性化脓性胆管炎(AOSC)的经验和效果。方法 回顾性分析成都军区总医院全军普通外科中心2001年9月至2007年12月收治的69例AOSC病人的损伤控制性手术和后续治疗的情况。结果 69例病人均经DCS治疗。外科重症监护病房（SICU）复苏后，18例病人痊愈，47例接受再次确定性手术。共治愈65例(94.2%)，再次确定性手术术后出现胆肠吻合口瘘、胆道出血各1例(各为2.1%)，经相应治疗痊愈；放弃治疗及死亡各2例(2.9%)，原因与DCS无关。结论 对于符合指征的AOSC病人，应根据不同的病因，积极选择适宜方式的DCS和再次确定性手术治疗。

Damage control surgery (DCS)for acute obstructive suppurative cholangitis(AOSC): a retrospective analysis of 69 cases

Damage control surgery (DCS)for acute obstructive suppurative cholangitis(AOSC): a retrospective analysis of 69 cases DAI Rui-wu, TIAN Fu-zhou, WANG Yu, et al. The PLA Center of General Surgery, Chengdu Army General Hospital of PLA, Chengdu 610083,China Corresponding author: TIAN Fu-zhou, E-mail:rwdai@163.com Abstract Objective To explore the current management strategy and effect of damage control surgery (DCS)for acute obstructive suppurative cholangitis(AOSC). Methods The clinical data of 69 AOSC patients who admitted in our center from Sep.2001 to Dec.2007 were selected as the object of this study. A retrospective analysis was done on preference of DCS methods and perioperative therapies. Results DCS was performed in all 69 patients. Then 18 patients were healed, 47 patients were performed reoperations after SICU resuscitation.The cure rate was 94.2% with 65 cases, The incidence of choleintestinal anastomotic stoma fistula(1 cases) or hemobilia(1 cases) was as low as 2.1% after reoperations, and all healed by corresponding treatments. Two cases abandoned treatment. Mortality rate was 2.9% with 2 cases, and the causes were irrespective with DCS. Conclusion Consideration for DCS should be made positively under indications to AOSC patients. According to the difference of etiopathogenesis, choosing eligible DCS and reoperations methods is the key management.