摘要
目的 评价游离空肠通道式胆道造口成形术治疗肝胆管结石并狭窄的远期疗效。方法 对 1988～ 1999年采用本术式治疗的 12 6例肝胆管结石并狭窄的临床资料进行回顾性分析。结果 本组术后共有 2 2例 (2 2 / 12 6 ,17 5 % )残余 (或复发 )结石 ,均采用切开胆道造口取石 ,结石取净率 (治愈率 )为 96 % (2 1/ 2 2 )。 30例 (30 / 12 6 ,2 3 8% )肝胆管结石并狭窄行胆道造口成形术治疗 ,随访10年无再狭窄发生。 12例术后因残余 (或复发 )结石并发急性梗阻性胆管炎再住院 ,做经皮穿刺经胆道造口引流 ,避免了急诊手术。采用本术式还成功地防止了逆行性胆道感染、消化性溃疡和盲端综合征等术后并发症。 10年中本组仅 1例发生胆总管末端狭窄需再次手术 ,经腹再手术率为 0 8% (1/12 6 )。结论 本术式可以显著地提高手术治疗肝胆管结石并狭窄的远期疗效。
Objective To evaluate the long term curative effects of choledochostomy and hepatocholangioplasty through a isolated jejunum passage on hepatolith complicated by stricture.Methods 126 cases suffering from hepatolith complicated by stricture were treated with this procedure from 1988 to 1999. Results Among the 126 cases, 12 cases were treated successfully with percutaneous paracentesis for drainage through the isolated jejunum passage for postoperative hepatolith complicated by acute cholangities, without the need for urgent operation. 22 cases found with postoperative residual or recurrent stones had the stones extracted through the stoma instead of relaparotomy. As a result, 21 of them were cured and the cure rate was 95 5%. 30 cases(23 8%) with complication of stricture due to hepatolith were treated with the operation and follow up of ten years found no recurrent stricture. The operation also successfully prevents reflux cholangities and other serious postoperative complications.During the postoperative period of ten years only one case (0 8%) had to undergo relaparotomy for recurrent stenosis of the end of CBD. [WT5”HZ] Conclusion[WT5”BZ] The procedure significantly improves the long term curative effects on hepatolith with stricture.
出处
《中华普通外科杂志》
CSCD
2000年第10期590-592,共3页
Chinese Journal of General Surgery
