损伤控制性理念用于急性梗阻性化脓性胆管炎中的外科处理

目的探讨损伤控制性外科（DCS）理念应用于急性梗阻性化脓性胆管炎（AOSC）的治疗经验和效果。方法回顾性分析大连大学附属中山医院胆道微创外科2009年1月至10月收治的24例AOSC患者的损伤控制性手术和后续治疗情况。结果23例患者经DCS治疗，12例患者痊愈，死亡1例，2例带塑料胆道内置管出院未行再次手术，8例接受再次确定性手术（7例治愈，1例放弃继续治疗）。再次手术术后2例（25％）出现切口感染，1例（12．5％）胆漏，经保守治疗痊愈。结论DCS联合再次确定性手术是治疗AOSC的一种安全、有效的方法。

Damage control strategy in acute obstructive suppurative cholangitis

Objective To investigate the current treatment strategy and effect of damage control surgery （ DCS ） for acute obstructive suppurative cholangitis （ AOSC ）. Methods The clinical data of 24 AOSC patients who admitted in our department from Jan. 2009 to Oct. 2009 were collected. The preference of DCS methods and perioperative therapies were analyzed by a retrospective analysis. Results DCS was performed in all 23 patients. Then 12 patients were healed, one patient died, two discharged with ERBD, 8 patients were performed reoperations after resuscitation. The cure rate was 87.5 % , the incidence of incisional infection（ 2 cases ） was 25 % and biliary leakage rate （ 1 cases ） was as low as 12.5 % after reoperations, and all healed by corresponding treatments. Conclusions DCS associated with reoperations methods was a relatively safe and effective management for AOSC cases.