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本文报告５７例重症胆管炎诊治体会。手术证实诊断符合率高达９０％。本组４８例是由胆管结石引起，仅少数病例是由胆管狭窄、胆道蛔虫引起。文献报告重症胆管炎第一死因是感染休克，肝脓肿败血症是第二死因。本组报告第一死因是脏衰、第二死因是感染休克。本组资料表明延误手术时机是造成死亡的重要因素。因此对休克病人术前准备时间不宜超过２～３小时。手术要简单有效，胆囊造瘘虽简单但引流不可靠，因此不宜作胆囊造瘘。
This article reports 57 cases of diagnosis and treatment of severe cholangitis experience. Surgery confirmed the diagnosis up to 90%. 48 cases of this group is caused by bile duct stones, only a few cases caused by biliary stricture, biliary ascaris. The literature reports that the first cause of death from severe cholangitis is septic shock, and liver abscess sepsis is the second leading cause of death. This group reported the first cause of death is dirty, the second cause of death is shock infection. This group of data shows that the timing of surgery is an important factor in causing death. Therefore, the preparation of shock patients preoperative time should not exceed 2 to 3 hours. Surgery should be simple and effective, although the simple gallbladder fistula drainage is not reliable, it is not appropriate for gallbladder fistula.