改良胆肠袢式吻合术治疗小儿胆管扩张症:附51例报告
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葛芙蓉, Email: 490983190@qq.com

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Modified loop biliary-enteric anastomosis for bile duct dilatation in children: a report of 51 cases
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    摘要:

    目的:探讨改良胆肠袢式(Warren)吻合术对先天性胆管扩张症患儿的临床疗效。 方法:回顾性分析2005年1月—2012年12月收治的51例先天性胆管扩张症患儿的临床资料,其中23例行改良的胆肠袢式吻合术(观察组),28例行胆管空肠Roux-en-Y吻合术(对照组),比较两组患儿术中及术后情况。 结果:与对照组比较,观察组手术时间、术中出血量减少,肠鸣音恢复时间、排气时间缩短(均P<0.05)。两组术后7 d肝功能指标差异均无统计学意义(均P>0.05)。术后观察组与对照组分别有1例、4例发生轻微胆汁反流,对照组有2例发生急性胆管炎,两组两种术后并发症发生率无统计学差异(均P>0.05)。 结论:改良胆肠袢式吻合术治疗先天性胆管扩张症操作简单、术后恢复快,近期疗效确切,但远期效果需进一步研究。

    Abstract:

    Objective: To evaluate the clinical efficacy of modified loop-type biliary-enteric (Warren) anastomosis in children with congenital bile duct dilatation (CBDD). Methods: The clinical data of 51 CBDD children treated form January 2005 to December 2012 were retrospectively analyzed. Of the children, 23 cases underwent modified loop-type bilioenteric anastomosis (observational group), while 28 cases received Roux-en-Y anastomosis (control group). The intra- and postoperative conditions between the two groups of children were compared. Results: In observational group compared with control group, the operative time and intraoperative blood loss was reduced, and the time to bowel sounds recovery and first flatus was shortened (all P<0.05). The differences in liver function parameters on postoperative day 7 between the two group showed no statistical significance (all P>0.05). One case in observational group and 4 cases in control group developed mild bile reflux, and 2 cases in control group developed acute cholangitis respectively after operation, but the incidences of the two postoperative complications showed no statistical difference between the two groups (both P>0.05). Conclusion: The modified loop-type bilioenteric anastomosis is a simple procedure for CBDD, with rapid postoperative recovery and demonstrable short-term efficacy. However, its long-term efficacy requires further observation.

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葛芙蓉.改良胆肠袢式吻合术治疗小儿胆管扩张症:附51例报告[J].中国普通外科杂志,2014,23(2):182-185.
DOI:10.7659/j. issn.1005-6947.2014.02.009

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  • 收稿日期:2013-09-27
  • 最后修改日期:2014-01-23
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  • 在线发布日期: 2014-02-15