摘要
目的探讨胆肠吻合术后再次手术的原因及处理方式。方法对22例院内外行Roux-Y胆肠吻合病人进行回顾性分析。结果肝内胆管结石伴扩张12例,肝内胆管结石伴吻合口狭窄5例,吻合口狭窄3例,慢性胰腺炎1例,胆管癌1例。再次手术行吻合口扩张整形后重新吻合13例,行肝叶切除术并取石3例,行空肠袢切开取石3例,行肝叶切除加吻合口扩张整形重新吻合2例,胆肠侧侧吻合改为端侧吻合1例,胆道下端通畅拆除胆肠吻合1例。12例随访,2例间断发生胆管炎。结论肝内胆管残留病变和吻合口狭窄是再次手术的主要原因。胆肠吻合手术选择应慎重、治疗应彻底。
Objective To explore the management of reoperation after cholangioenterostomy. Methods The reoperative data of 22 patients were introduced. Results There were 12 cases of intrahepatic stone and expression, 5 cases of intrahepatic stone and anastomotic strictur, 3 cases of anastomotic strictur. 1 case of chronic pancreatitis, 1 cases of cholangiocarcinoma. 13 cases were sub- jected to reanastomosis after enlarging the primary anastomsis. 3 cases were subjected to hepatic resection. 3 cases hepatic resection were withdrawed by jejunum. 2 cases were ubjected to hepatic resection and reanastomosis. 1 case side-to-side anastomos changed to end-to-side anastomos. 1 case cholangioenterostomy was demolished . 12 cases were follow-uped, 2 cases cholangitis broke out inter- ruptly. Conclusions Intrahepatic biliary disease and joint narrow were major reason of reoperation. We should perform cholangioenterostomy carefully and thoroughly.
出处
《肝胆外科杂志》
2012年第4期274-276,共3页
Journal of Hepatobiliary Surgery
关键词
胆肠吻合
狭窄
再次手术
cholangioenterostomy
stricture
reoperation
