胆道内留置输液港管在复发性胆总管结石治疗中的初步应用OA
Preliminary clinical application of indwelling infusion ports tube in the biliary tract for treatment of recurrent common bile duct stones
目的 分析胆道内留置输液港管在治疗复发性胆总管结石中的应用效果,评估其安全性和可行性.方法 回顾性分析2018年6月至2024年6月于大连医科大学附属大连市友谊医院肝胆外科因复发性胆总管结石行胆道内留置输液港管并埋置于皮下的患者临床资料,随访观察术后结石残留、结石复发和并发症情况.结果 研究共纳入23例患者,行胆道内留置输液港管并埋置于皮下手术后,发生结石残留1例(4.3%),行经输液港管窦道扩道取石治疗.术后结石复发3例(13.0%),其中1例术后3年复发,行经输液港管窦道扩道取石治疗,术后再次留置输液港管;1例术后5年结石复发,复发时患者恶性肿瘤晚期,未进一步治疗;1例术后3年拔除输液港管,拔除后1年结石复发,行开腹胆总管切开取石、T管引流、肠粘连松解术,术后再次行经T管窦道输液港管置入.术后出现皮下固定输液港管处皮肤感染6例(26.1%),通过保守治疗或局部处理治愈.结论 本研究初步报告胆道内留置输液港管并皮下埋置这一技术在复发性胆总管结石患者中的可行性、安全性以及短期疗效,可以延长结石复发时间和降低结石复发率.
Objective To evaluate the effectiveness,safety,and feasibility of indwelling infusion ports tube in the biliary tract for treatment of recurrent common bile duct stones.Methods A retrospective analysis was conducted on patients with recurrent common bile duct stones who underwent placement of infusion ports tubes in the biliary tract with subcutaneous embedding in the Affiliated Dalian Friendship Hospital of Dalian Medical University between June 2018 and June 2024.Postoperative outcomes,including stone residue,recurrence,and complications,were followed up and evaluated.Results A total of 23 patients underwent indwelling infusion ports tube in the biliary tract with subcutaneous implantation.Postoperative residual stones were observed in one patient(4.3%),who underwent successful stone removal via the sinus tract established through the infusion ports.Three cases of stone recurrence were reported(13.0%):one patient experienced recurrence three years after surgery and was successfully treated with sinus tract dilation and stone extraction via the infusion port,followed by re-implantation of the catheter;one patient experienced recurrence five years postoperatively but did not undergo further treatment due to advanced malignancy at the time of recurrence;one patient had the infusion port removed three years postoperatively,and experienced recurrence one year later,requiring open common bile duct exploration,T-tube drainage,and intestinal adhesion lysis;a new infusion port catheter was reinserted via the T-tube tract postoperatively.Six patients(26.1%)developed localized skin infections at the subcutaneous port site,all of which resolved after conservative treatments or topical treatments.Conclusion This study preliminarily reported the feasibility,safety,and short-term efficacy of indwelling infusion ports tube in the biliary tract with subcutaneous implantation for patients with recurrent common bile duct stones.This technique may prolong the recurrence interval and reduce the stone recurrence rate.
杜开放;王希春;魏磊;赵昌志;冯众一;程明杰;李函硕;郎桂玲
大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001大连医科大学附属大连市友谊医院肝胆外科/大连市肝胆外科研究所,辽宁 大连 116001
医药卫生
复发性胆总管结石输液港管胆道内留置胆道内引流
recurrent common bile duct stonesinfusion ports tubeindwelling in biliary tracyintra-biliary drainage
《肝胆胰外科杂志》 2026 (6)
396-400,5
大连市医学科学研究计划项目(2311017)大连市友谊医院科研启动经费项目(FH2022026).
评论