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目的探讨糖尿病合并肝脓肿患者手术时机及手术方式的选择。方法北京市通州区潞河医院1998年9月～2009年10月收治的36例糖尿病合并肝脓肿患者中,手术治疗21例;B超引导下穿刺引流8例;腹腔镜下引流3例;非手术治疗4例。手术治疗21例中,单纯脓肿引流12例,脓肿引流+胆囊切除7例,脓肿引流+胆囊切除+胆总管探查2例;腹腔镜治疗3例中,单纯脓肿引流2例,脓肿引流+胆囊切除1例。结果手术死亡2例;非手术治疗死亡1例;B超引流中3例引流不畅,重新手术治疗,其余患者均治愈。结论糖尿病合并肝脓肿病情复杂,要根据患者情况、脓肿位置、大小、数目、有无合并症,合理选择手术时机及手术方式。
Objective To investigate the timing of operation and the choice of surgical procedure in diabetic patients with liver abscess. Methods Twenty-six patients with diabetes mellitus and liver abscess treated in Luhe Hospital, Tongzhou District, Beijing from September 1998 to October 2009 were treated surgically (n = 21), puncture and drainage under ultrasound B (n = 8), laparoscopic drainage Surgical treatment in 4 cases. Surgical treatment of 21 cases, simple abscess drainage in 12 cases, abscess drainage + cholecystectomy in 7 cases, abscess drainage + cholecystectomy + common bile duct exploration in 2 cases; Laparoscopy in 3 cases, simple abscess drainage in 2 cases, abscess drainage + cholecystectomy 1 case. Results 2 cases died of surgery; 1 case died of non-surgical treatment; 3 cases of B-drainage in poor drainage, re-operation, the remaining patients were cured. Conclusions Diabetic patients with liver abscess complicated by the disease should be based on the patient’s condition, abscess location, size, number, with or without complications, reasonable timing and surgical options.