A comparison of spur valve and percutaneous enterostomy in Roux-Y portoenterostomy for biliary atresia  

胆道闭锁手术空肠胆支造瘘与防返流瓣的比较研究(英文)

作　　者：刘钧澄[1] 李桂生[1] 

机构地区：[1]中山医科大学附属第一医院小儿外科,广州510080

出　　处：《Chinese Medical Journal》2001年第9期90-91,110-111,共4页中华医学杂志（英文版）

摘　　要：Objective　To compare the advantages and disadvantages of two procedures: Roux-Y with enterostomy and Roux-Y with spur valve in the treatment of biliary atresia.Methods　Twenty-four patients with biliary atresia underwent hepatic portoenterostomy with percutaneous jejunal enterostomy (Group A) and 24 patients underwent Roux-Y with antireflux spur valve (Group B). Clinical data were reviewed retrospectively.Results　Ten patients remained alive in the Group A. Among them, 9 survived without jaundice, the oldest one being 9-years old. One of the 9 patients had portal hypertension. The remaining one who survived with jaundice and portal hypertension was 8-years old at follow up. Ten patients in the Group B remained alive. Of them, 8 survived without jaundice and 2 with jaundice.Conclusions　Two surgical procedures had similar effects in preventing reflux cholangitis, while spur valve has the benefit of quitting cutaneous enterostomy.目的　对肝门空肠吻合加空肠胆支造瘘术与加胆支防返流瓣成形术 ,这两种术式的优缺点进行比较。方法　A组 2 4例胆道闭锁行肝门空肠Roux Y吻合 ,空肠胆支造瘘术。B组为另外 2 4例行肝门空肠Roux Y吻合 ,空肠胆支防返流瓣成形术。对这两组术后情况进行回顾性分析。结果　A组 10例存活 ,无黄疸 9例 ,最大的已 9岁 ,1例出现肝脾肿大、食道静脉曲张。 1例带黄疸存活并出现门脉高压 ,现已 8岁。B组存活 10例 ,其中无黄疸存活 8例。结论　两组病例术后排胆汁 (或排黄绿色大便 )时间、胆管炎发生次数等临床表现进行了比较。排胆汁时间相似 ,无显著差异。术后胆管炎发生率也无显著差异。两种手术都有防返流作用 ,而空肠胆支防返流瓣免除了经皮肤的空肠胆支造瘘。

关 键 词：biliary atresia  ·   cholangitis  ·   hepatic portoenterostomy  ·  antireflux spur valve 

分 类 号：R657.4[医药卫生—外科学]