摘要
目的探讨胆肠吻合术后再手术的原冈及处理方法。方法回顾性分析我院1999年1月～2004年12月21例胆肠吻合术后再手术患者的临床资料。结果21例中初次手术行胆总管囊肿肠吻合6例，胆肠侧侧吻合7例，胆肠端侧吻合7例，胆肠侧端吻合1例。术后19例结石复发或残留，14例吻合口狭窄。再手术方法：全组均行规范胆管空肠Roux—en—Y式端侧吻合术，加行左肝外叶切除4例，其中1例行左肝管、肝门部且日管与空肠双口端侧吻合。结论原发胆道病未能根治或复发及胆肠吻合口狭窄是再手术的主要原因，其次是术式选择不当，手术不规范。再手术应遵循“去除病灶、解除梗阻、通畅引流”的原则，选择正确术式，规范操作，避免手术技术缺陷。
Objective To investigate the causes and surgical procedures of the reoperation indicated by previous choledochoenterostomy. Methods 21 cases of reoperation indicated by previous choledochoenterostomy hospitalized in our hospital from January 1999 to December 2004 were retrospectively reviewed. Result The previous procedures were cystojejunostomy in 6 cases, side to side choledochoenterostomy in 7 cases, end to side choledochoenterostomy in 7 cases, and side to end choledochoenterostomy in 1 case. 19 cases were found recurrent or residual lithiasis, and 14 cases had anastomotic stricture. The procedures of reoperation were Roux-en-Y choledochoenterostomy in all cases, including 4 cases had additional left lateral segmentectomy, 1 case had double anastomosis of left and hilar hepatojejunostomy. Conclusion The residual or recurrent primary lesion and anastomotic stricture mainly contribute to the demand of reoperation, indicating a probably compromised primary surgery. Completely removal of the primary lesion and unobstructed drainage via anastomosis should be achieved to the best in reoperation.
作者
江晓华
钟德玝
苗雄鹰
刘国利
王群伟
段伦喜
JIANG Xiao-hua ZHONG De-wu, MIAO Xiong-ying, LIU Guo-li, WANG Qun-wei, DUAN Lun-xi （Departement of Hepatobiliary Surgery, Second Xiangyan Hospital, Central South University, Changsha 410011 , Hunan, China）
出处
《中国现代手术学杂志》
2005年第5期330-332,共3页
Chinese Journal of Modern Operative Surgery
