Nursing Observation and Intervention of Extrahepatic Bile Duct Stones with Gallstones Treated with Electronic Duodenoscopic Sphincterotomy Combined with Laparoscopic Cholecystectomy_West China Medical Journal

Authors：

 ZHOUJie , LIJin-long

The First Surgical Ward, the Fourth People's Hospital of Sichuan Province, Chengdu, Sichuan 610016, P. R. China;

Corresponding author：

Keywords：

Electronic duodenoscopic sphincterotomy; Laparoscopic chole cystectomy; Observation and intervention of postoperative nursing

DOI：

10.7507/1002-0179.20150323

Video：

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Objective To investigate the importance of nursing observation and intervention for extrahepatic bile duct stones with gallbladder stones treated by electronic duodenoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy (LC). Methods From July 2011 to February 2014, 157 patients with extrahepatic bile duct stones with gallbladder stones underwent EST and LC at the same time in our department. Combined with the surgery characteristics, we focused on the close observation and nursing of postoperative complications and drainage tubes for patients' timely recovery. Results One patient with duodenal diverticulum papilla did not complete EST and LC surgery, which was then transformed to LC, bile duct incision and choledochoscopy with T tube drainage. All the remaining 156 patients completed endoscopic retrograde cholangio-pancreatography and LC with a completion rate of 99.36%. Under close observation and careful nursing care, this group of patients did not have duodenum perforation, bile leakage or other complications. No patient died. Seven to thirteen days after hospitalization, all the patients were cured and discharged from the hospital. Conclusion For patients undergoing EST and LC at the same time, observation and timely intervention are very important in reducing serious complications, improving the quality of surgery, enhancing patients' comfort, and promoting postoperative recovery.

Citation： ZHOUJie, LIJin-long. Nursing Observation and Intervention of Extrahepatic Bile Duct Stones with Gallstones Treated with Electronic Duodenoscopic Sphincterotomy Combined with Laparoscopic Cholecystectomy. West China Medical Journal, 2015, 30(6): 1123-1126. doi: 10.7507/1002-0179.20150323 Copy

1.	罗云藩, 邓予, 景英朝, 等. 腹腔镜胆囊切除术联合十二指肠镜乳头切开术治疗胆石症[J]. 右江民族医学院学报, 2005, 27(3):350-351.
2.	李金龙, 李荣祥, 何平, 等. LC联合EST在胆囊结石伴肝外胆管结石中的应用[J]. 肝胆外科杂志, 2005, 13(6):458-459.
3.	黄业凤. 腹腔镜胆囊切除术后并发症发生的原因分析及护理干预[C]//中华护理学会第8届全国造口、伤口、失禁护理学术交流会议, 全国外科护理学术交流会议, 全国神经内、外科护理学术交流会议论文集. 广州:中华护理学会, 2011:240-242.
4.	龚霞玲. 腹腔镜胆囊切除术并发症观察护理[J]. 中国民族民间医药, 2013, 22(14):159.
5.	何平, 李金龙, 张乙川, 等. 肝胆手术后胆漏的原因、预防和治疗[J]. 吉林医学, 2010, 31(22):3628-3630.
6.	王伟. 腹腔镜胆囊切除术后并发症的观察及护理[J]. 中国现代药物应用, 2014, 8(14):193-194.
7.	温秀英. 浅谈腹腔镜胆囊切除术(LC)的围手术期的护理[J]. 健康必读, 2012, 11(7):459.
8.	杨建锋, 张啸, 张筱凤. 内镜下逆行胰胆管造影并发十二指肠穿孔15例诊治分析[J]. 中华胃肠外科杂志, 2012, 15(7):682-686.
9.	蒋艳, 单雪莲, 毛鑫群. ERCP术后并发十二指肠穿孔的早期观察和护理[J]. 护士进修杂志, 2009, 24(19):1782-1783.
10.	周洁, 李金龙, 张乙川, 等. 重视内镜逆行胰胆管造影术围手术期的护理[J]. 中外医学研究, 2013, 11(35):89-90.
11.	李金龙, 张福鑫, 李劲, 等. 介入栓塞治疗在EST术后大出血中的应用[J]. 中华消化内镜杂志, 2009, 26(10):543-544.
12.	张啸, 钱礼. 内镜下乳头切开术的近期并发症[J]. 中华消化内镜杂志, 1996, 13(5):290-292.
13.	王书智, 叶志霞, 胡冰, 等. 止血夹与药物联用预防乳头括约肌大切开术后出血的效果观察[J]. 解放军护理杂志, 2006, 23(4):51-52.
14.	黄永德, 胡团敏, 张成华, 等. ERCP联合LC治疗胆囊结石合并胆总管结石的临床价值[J]. 现代消化及介入诊疗, 2011, 16(5):332-334.
15.	董建花. 鼻胆管引流术后的护理[J]. 中国医药指南, 2014, 12(27):292-293.
16.	梁和业, 乔秀丽, 王晓丰, 等. ERCP后即时LC在治疗胆囊结石合并胆总管结石中的应用价值[J]. 胃肠病学和肝病学杂志, 2013, 22(7):704-705.
17.	陈彩芳, 蔡秋凤. 双镜联合治疗肝外胆道结石的护理体会[J]. 实用临床医药杂志, 2014, 18(4):85-86.

1. 罗云藩, 邓予, 景英朝, 等. 腹腔镜胆囊切除术联合十二指肠镜乳头切开术治疗胆石症[J]. 右江民族医学院学报, 2005, 27(3):350-351.
2. 李金龙, 李荣祥, 何平, 等. LC联合EST在胆囊结石伴肝外胆管结石中的应用[J]. 肝胆外科杂志, 2005, 13(6):458-459.
3. 黄业凤. 腹腔镜胆囊切除术后并发症发生的原因分析及护理干预[C]//中华护理学会第8届全国造口、伤口、失禁护理学术交流会议, 全国外科护理学术交流会议, 全国神经内、外科护理学术交流会议论文集. 广州:中华护理学会, 2011:240-242.
4. 龚霞玲. 腹腔镜胆囊切除术并发症观察护理[J]. 中国民族民间医药, 2013, 22(14):159.
5. 何平, 李金龙, 张乙川, 等. 肝胆手术后胆漏的原因、预防和治疗[J]. 吉林医学, 2010, 31(22):3628-3630.
6. 王伟. 腹腔镜胆囊切除术后并发症的观察及护理[J]. 中国现代药物应用, 2014, 8(14):193-194.
7. 温秀英. 浅谈腹腔镜胆囊切除术(LC)的围手术期的护理[J]. 健康必读, 2012, 11(7):459.
8. 杨建锋, 张啸, 张筱凤. 内镜下逆行胰胆管造影并发十二指肠穿孔15例诊治分析[J]. 中华胃肠外科杂志, 2012, 15(7):682-686.
9. 蒋艳, 单雪莲, 毛鑫群. ERCP术后并发十二指肠穿孔的早期观察和护理[J]. 护士进修杂志, 2009, 24(19):1782-1783.
10. 周洁, 李金龙, 张乙川, 等. 重视内镜逆行胰胆管造影术围手术期的护理[J]. 中外医学研究, 2013, 11(35):89-90.
11. 李金龙, 张福鑫, 李劲, 等. 介入栓塞治疗在EST术后大出血中的应用[J]. 中华消化内镜杂志, 2009, 26(10):543-544.
12. 张啸, 钱礼. 内镜下乳头切开术的近期并发症[J]. 中华消化内镜杂志, 1996, 13(5):290-292.
13. 王书智, 叶志霞, 胡冰, 等. 止血夹与药物联用预防乳头括约肌大切开术后出血的效果观察[J]. 解放军护理杂志, 2006, 23(4):51-52.
14. 黄永德, 胡团敏, 张成华, 等. ERCP联合LC治疗胆囊结石合并胆总管结石的临床价值[J]. 现代消化及介入诊疗, 2011, 16(5):332-334.
15. 董建花. 鼻胆管引流术后的护理[J]. 中国医药指南, 2014, 12(27):292-293.
16. 梁和业, 乔秀丽, 王晓丰, 等. ERCP后即时LC在治疗胆囊结石合并胆总管结石中的应用价值[J]. 胃肠病学和肝病学杂志, 2013, 22(7):704-705.
17. 陈彩芳, 蔡秋凤. 双镜联合治疗肝外胆道结石的护理体会[J]. 实用临床医药杂志, 2014, 18(4):85-86.

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West China Medical Journal

Nursing Observation and Intervention of Extrahepatic Bile Duct Stones with Gallstones Treated with Electronic Duodenoscopic Sphincterotomy Combined with Laparoscopic Cholecystectomy

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