患者,女性,69岁。因反复腹胀、便秘半年,加重10余天,于1997年2月18日入院。B超提示化脓性胆管炎。经内科抗感染等保守治疗后无好转,于入院后第3天转外科治疗,转科时体查：皮肤及巩膜轻度黄染,心肺听诊无异常,下腹胀,全腹肌紧张,压痛、反跳痛明显,以右侧腹部为甚,肝脾触诊不满意 Patient, female, 69 years old. Due to repeated abdominal distension and constipation for more than 10 days, he was admitted to the hospital on February 18, 1997. B ultrasound prompted suppurative cholangitis. After medical treatment such as anti-infection and other conservative treatment did not improve, turn to surgery on the 3rd day after admission, physical examination when transferred: skin and sclera mild yellow, no abnormal heart and lung auscultation, abdominal distension, full abdominal muscle tension, tenderness, Bounce pain is obvious, right to the abdomen is very bad, liver and spleen are not satisfied with palpation