两种胆肠内引流术临床效果的比较
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张志伟 E-mail:zhangzw2225@126.com

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Comparison of clinical outcome of |two types of choledochojejunostomy
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    摘要:

    目的:比较改良襻式胆肠内引流术与胆肠Roux-en-Y内引流术的临床疗效。
    方法:回顾性分析84例采用不同胆肠内引流者的临床资料。按随机分组原则行胆肠改良襻式内引流术39例和胆肠Roux-en-Y内引流术45例,并随访1~2年,比较两组的手术操作时间、减黄效果、术后肠道功能恢复时间、胆管炎发生率。
    结果:两组具有相同的减黄效果。两组的手术吻合时间分别为(53±112)min和(72.4±9.5)min;术后肠道功能恢复时间分别为(79.2±4.4)h和(93±6.5)h;胆管炎发生率分别为5.1%和13.3%。改良袢式组各项指标优于Roux-en-Y组,均有统计学意义(均P<005)。
    结论:改良襻式胆管-空肠内引流术的近期和长期疗效肯定,可作为胆肠内引流的首选手术方式。

    Abstract:

    Objective:To compare the therapeutic effects of modified  loop choledochojejunostomy and  the Roux-en-Y choledochojejunostomy.
    Methods:Clinical data of 39 cases of modified loop choledochojejunostomy (ML) and 45 cases of Roux-en-Y choledochojejunostomy (R-Y) were analysed and compared, The patients of the 2 groups were followed-up for 1 to 2 years. The operation time, time to recovery of bowel function,  serum level of total bilirubin and the morbidity  of cholangitis between the 2 groups were compared.
    Results:The postoperative serum level of total bilirubin decreased to the same level in both groups (P>0.05). Im ML grpup and R-Y group, the operation time were (53±11.2)min and (72.4±9.5)min, the time to recovery of bowel flatus (79.2±4.4)h and(93±6.5)h, and the morbidity  of cholangitis were 5.1% and 13.3%, srespectiveely. The observed indexes in the ML group were statistically better than those  in the R-Y group (P<0.05).
    Conclusions:The short-term and long-term therapeutic effects of modified loop choledochojejunostomy are good; the modified operation can be the method of choice for choledochojejunostomy.

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张志伟| 尹昌生| 荆信彬| 江志杰| 陈本文.两种胆肠内引流术临床效果的比较[J].中国普通外科杂志,2011,20(3):276-278.
DOI:10.7659/j. issn.1005-6947.2011.03.016

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  • 收稿日期:2010-11-10
  • 最后修改日期:2011-02-14
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  • 在线发布日期: 2011-03-15