两种肝门胆管成形胆道重建手术疗效的对比
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李蕊

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Comparison of two treatment reconstruction modalities for hilar bile duct stricture
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    目的:探讨肝门部胆管炎症性狭窄的有效治疗方法。方法:回顾性分析近10年间因肝内胆管结石行带血管蒂胆囊瓣肝门胆管成形术(PHBDS)及胆管空肠Roux-en-Y吻合术(RYCJ)治疗的肝门胆管炎症性狭窄患者的临床资料。观察围手术期的情况和术后胆管炎发生率、结石复发率。结果:两组间围手术期胆漏、炎性肠梗阻的发生率无统计学意义,PHBDS组与RYCJ组术后胆管炎发生率分别为5.66%和21.88%(P=0.010)。胆管结石发生率分别为3.77% 和16.67%(P=0.021)。结论:PHBDS手术操作简单安全,保留了Oddi括约肌功能,防止了胆肠反流的发生,治疗效果优于RYCJ组。

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    Abstract:Objective: To explore an effective treatment for inflammatory hilar bile duct stricture. Methods: The clinical data with patients of intra-hepatic cholelithiasis complicated with hilar bile duct stricture that received plastic repair of hilar bile duct stricture(PHBDS) with pedicled cholecystic graft or Roux-en-Y cholangio-jejunostomy(RYCJ) in our hospital during recent 10 years were retrospectively analyzed. The peri-operative conditions, postoperative morbidity of cholangitis and recurrence of hepaticolithiasis were observed. Results:The peri-operative morbidity of biliary fistula and inflammatory ileus were not significantly different between the two groups. The postoperative morbidity rate of cholangitis was 5.66% and 21.88%,(P=0.010) and recurrence rate of hepaticolithiasis was 3.77% and 16.67%,(P=0.021) in PHBDS group and RYCJ group respectively. Conclusions:PHBDS is an easy and safe operation. RHBDS can preserve the physiologic function of Oddi′s spincter, so the reflux of intestinal contents to bile duct is avoided, and the results are better than the RVCJ.

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李蕊,米曰堂,李学华,杨凤辉,邵峰,张彦波.两种肝门胆管成形胆道重建手术疗效的对比[J].中国普通外科杂志,2005,14(1):5-.
DOI:10.7659/j. issn.1005-6947.2005.01.005

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  • 在线发布日期: 2005-01-25