胆总管十二指肠吻合术治疗胆总管结石420例的远期疗效分析  

Long-term result of choledochoduodenostomy for the treatment of bile duct calculi in 420 cases

作　　者：杨维良[1] 张东伟[1] 张新晨[1] 赵志[2] 张建国[3] 裴建华[4] 

机构地区：[1]哈尔滨医科大学附属第二医院普外科,150086 [2]牡丹江医学院附属医院普外科 [3]佳木斯市中心医院普外科 [4]大庆油田总院普外科

出　　处：《中华普通外科杂志》2005年第10期638-640,共3页Chinese Journal of General Surgery

摘　　要：目的分析胆总管十二指肠吻合术的远期疗效。方法回顾性分析1962—2002年胆总管十二指肠吻合术420例的临床资料。结果1982年以前230例,其中46例因吻合口狭窄致胆管炎或胆总管盲端综合征,6例死亡,死亡率2.6%(6/230);1983年后190例,强调低位大口径吻合,其中7例出现胆管炎或胆总管盲端综合征,无死亡病例。吻合口径<2.0cm110例,2.0～2.5cm184例,2.5～3.0cm107例,资料不详19例。经2～20年随访358例,随访率为85.2%,其中1983年之后手术效果优良率为96.3%(183/190)。结论胆总管十二指肠吻合口径要>2.5cm,吻合口位置要低,才可避免逆行性感染和胆总管盲端综合征。Objective To evaluate the effect of choledochoduodenostomy for the treatment of bile duct calculi. Methods Clinical data of 420 patients with choledochoduodenostomy from 1962 to 2002 were respectively analyzed. Results Before 1982, this procedure was performed in 230 cases with postoperative cholangitis or sink syndrome found in 46 cases, and mortality in 6 cases. Since 1983,190 cases underwent large-sized choledochoduodenostomy with 7 cases suffering from postoperative cholangitis or sink syndrome and no mortality. The anastomotic stoma was less than 2. 0 cm in 1 10 cases, between 2.0 to 2.5 cm in 184 cases, from 2. 5 to 3.0 cm in 107 cases, no record in 19 cases. A total of 358 cases （85.2%） were followed up from 2 to 20 years. Result was excellent and good in 183 out of 190 cases（96. 3% ） after the year of 1983. Conclusions Choledochoduodenostomy when the stoma was larger than 2. 5 cm in diameter and was put low in position was effective for the prevention of recurrent cholangitis and sink syndrome for the treatment of bile duct calculi.

关 键 词：胆总管结石 胆总管造口术 胆管十二指肠吻合术 

分 类 号：R657.4[医药卫生—外科学]