急性胆道疾病严重威胁病人生命。病情危重病人的急诊手术治疗预后较差。我科整合多学科优势，总结经验，对胆道急症病人采取分阶段处理，大大改善预后。对于急性重症胆囊炎病人，先行经皮经肝胆囊穿刺引流缓解梗阻，择期手术治疗，显著降低胆道损伤发生率、术后死亡率和重症监护病房入住率。对于胆囊管通畅的胆源性胰腺炎病人，先行经皮经肝胆囊穿刺引流缓解胰腺炎症状，择期行内镜乳头括约肌切开或腹腔镜胆总管探查术，更安全。对于胆管扩张的肝内外胆管结石病人，先行内镜鼻胆管引流或经皮经肝胆管穿刺引流解除梗阻，大大提高生存率。对于胆道恶性肿瘤伴黄疸病人，应用经皮经肝胆管穿刺引流或内镜鼻胆管引流尽早减黄，之后经皮经肝胆管穿刺引流置入支架以达到延长生命的目的。

Acute biliary tract disease has serious threat for the patient life. Emergency surgery for critical patients tends to poor prognosis. Multidisciplinary advantages were integrated and the experiences were summarized in our department which showed that staged treatment of patients with biliary emergency would improve the prognosis greatly. For the patients with acute severe cholecystitis, percutaneous transhepatic gallbladder drainage (PTGBD) was performed first to relieve obstruction and elective surgical treatment was done then, which could reduce significantly the rates of biliary tract injury and postoperative mortality and the rate of intensive care unit admission. It was safer for patients with biliary pancreatitis that firstly PTGBD was performed to relieve the symptoms of pancreatitis, and elective endoscopic sphincterotomy or laparoscopic common bile duct exploration was performed. It is the first to relieve biliary obstruction for the patients of intrahepatic and extrahepatic bile duct stones with bile duct dilatation using endoscopic nasobiliary drainage (ENBD) or percutaneous transhepatic cholangiodrainage (PTCD), which would improve the survival rate greatly. PTCD or ENBD could be used for the patients with malignant tumor in biliary tract to reduce jaundice as early as possible. And then, stent was implanted through PTCD to prolong life.