摘要
目的为提高对胆总管末端良性狭窄的认识，作出正确诊断和治疗。方法随访分析４６例的主要临床表现、病因、诊断方法和手术疗效。男１２例、女３４例，年龄３５～６８岁，平均５１．５岁。胆囊切除术后８例，胆囊切除加胆总管切开探查术后３２例，胆源性复发性胰腺炎４例，内窥镜下括约肌切开术（ＥＳＴ）后２例。其中第一次手术后３８例，第二次手术后８例。作胆总管空肠吻合术１８例。行Ｏｄｄｉ括约肌切开成形术２８例，其中加作壶腹间隔切开成形术３例。结果腹部切口感染２例，短暂性胆漏２例，黑便１例。胆总管空肠吻合术１８例已另文报告，２８例Ｏｄｄｉ括约肌切开成形术中２４例（８５７％）经２～１０年随访效果满意。结论胆总管末端良性狭窄是胆囊切除术后综合征中常见的原因之一。作针对性Ｏｄｄｉ括约肌切开成形可获满意效果。
Objective To improve the understanding of stenosis at the end of common bile duct for correct diagnosis and treatment.Methods Major clinical symptoms,pathogenesis,diagnostic procedure and the result of operation of 46 cases were reviewed and evaluated.Eight patients had a history of cholcystectomy and 32 with a history of cholecystectemy plus choledocholithotomy,4 had a history of biliary recurrent pancreatitis in 4 and post EST in 2.Thirty eight had a history of previos biliary surgery.18 underwent transduodenal sphincterplasty (TDSP),and transampullary septectomy (TAST) was added to 3 of the 28 cases receiving hepatojejunal Roux en Y anastomosis.Results Incisional infection occurred in 2,transient bilileak in 2,and melena in one.24 (85 7%) of 28 TDSP were followed up for 2～10 years,and the result was excellent.Conclusions Stenosis at the end of CBD is one of the most common causes of the so called post cholecystectomy syndrome.The result of TDSP is the treatment of choice for this syndrome.
出处
《中华普通外科杂志》
CSCD
1999年第3期208-210,共3页
Chinese Journal of General Surgery
关键词
胆总管疾病
外科手术
狭窄
良性
诊断
Common bile duct diseases Stenosis Surgery,operative
