肝门部胆管狭窄的外科治疗  

Surgical treatment for hilar bile duct stricture

作　　者：何振平[1] 王敖川[1] 韩本立[1] 张全周[1] 何云[1] 顾红光[1] 李智华[1] 黄志强[1] 

机构地区：[1]第二军医大学西南医院肝胆外科中心,湖南零陵地区医院

出　　处：《中华外科杂志》1994年第5期266-268,共3页Chinese Journal of Surgery

摘　　要：作者报告了１９７５年～１９９２年治疗４７４例肝门部胆管狭窄的经验。４７４例中既往接受１～５次手术者７４．７％。狭窄的病因：原发性肝胆管结石者７１．７％；损伤性胆符狭窄者１０．９％；化脓性胆管炎者７．１％。其他少见。狭窄部位：左肝管３７．６％；小肝管＋右肝管＋肝总管１７．４％，右肝管９．６％；肝总管１４．７％；左肝管＋右肝管１１．５％。胆管下端狭窄与松弛者分别为２３．６％与４８．８％。治疗方式：狭窄切开整形５６．５％；扩张与支撑１５．２％；肝叶切除４８％；修补１０．４％；胆肠吻合６０．７６％。门静脉减压手术６．３％。文中讨论了引起狭窄的原发病的病理改变及与狭窄显露、治疗方法选择的关联，肝方叶处理的方法及选用。Abstract474 patients suffering from hilar bile duct stric-tures were treated from 1975 to 1992.74.7% of the patients had a history of biliary surgery for 1～5times. Causes of strictures were of iatrogenic in10.9%,of primary in 71.7%, and of suppurative in7.1%. Site of strictures:LHD in 37.6%,LHD+RND+CND in 17.4%,RHD in 9.6%,CHD in 14.7%,and LHD+RND in 11.5%。The inferior endof the CBD were of spasmodic or flaccid in 23.6%and48.3%,respectively,Treatment included cholangio-plasty in 56.5%, dilatation and stent in 15.2%,lobec-tomy and segmetectomy of involtied liver in 48%,re-pairing in 11.4%,bilio-enterostomy in 60.7%, andportal vein decompression in 6.3%.

关 键 词：外科手术 吻合术 胆道狭窄 

分 类 号：R657.46[医药卫生—外科学]