摘要
目的 探讨肝内、外胆管良性疾病行胆肠吻合术式的选择与远期效果。方法 对 1981年 1月至 2 0 0 0年12月 614例行胆肠吻合术病例进行总结。原发疾病包括 :原发性肝内胆管结石和 (或 )胆管狭窄 3 2 1例 (5 2 .3 % ) ,先天性胆总管囊肿 10 6例 (17.3 % ) ,医源性胆管损伤 15 1例 (2 4.6% ) ,其它 3 6例 (5 .9% )。其中胆管 (或囊肿 )十二指肠吻合术 89例 ,胆管 (或囊肿 )空肠吻合术 5 2 5例 ;手术死亡 18例 ,术后获随访 5 2 4例 ,随访时间为 1～ 2 0年 ,随访率为 87.9%。结果 随访效果属优、良者占 84.5 % ;再手术率 :胆管 (或囊肿 )十二指肠吻合术为 49.4% ,胆管 (或囊肿 )空肠侧 -侧吻合术为 14 .2 % ,胆管空肠端侧 -侧吻合术 4.4% ,三组间差异有显著性意义 (P<0 .0 1)。结论 肝内、外胆管良性疾病行胆肠吻合术时 ,胆管 (或囊肿 )十二指肠吻合术式应废除 ,胆管空肠 (Roux en Y)端侧 -侧吻合术式应作为首选 。
Objective To investigate the chole enterostomy type and the long term results in treatment of benign diseases of biliary tract. Methods A total of 614 cases of chole enterostomy from January 1981 to December 2000 were followed up and analysed. The original diseases: 321 were original hepatolithiasis and/or bile duct stricture (52.3%), 106 congenital cyst of common bile duct (17.3%), 151 iatrogenic bile duct injury (24.6%) and others 36 cases (5.9%). Choledochoduodenostomy was performed in 89 cases and choledochojejunostomy in 525 cases. Five hundred and twenty four cases have been followed up for 1 to 20 years. The rate of follow up was 87.9%. Results In 84.5% of the cases, excellent or good long term results were achieved. Re operation rate were 49.4% in cases of choledochoduodenostomy or cystoduodenostomy, 14.2% in side side (cyst) cholangio jejunostomy and 4.4% in end side cholangiojejunostomy, respectively. Conclusion The choledochoduodenostomy should be abolished. The end side cholangiojejunostomy shoud be the best choice when it is needed to perform choledochojejunostomy in benign bile duct diseases and can promise a satisfactory long term result.
出处
《中国普外基础与临床杂志》
CAS
2002年第3期191-193,共3页
Chinese Journal of Bases and Clinics In General Surgery
