第Ⅲ段肝管空肠吻合解除肝门部胆管恶性梗阻  

HEPATIC CHOLANGIOJEJUNOSTOMY AS A PALLIATIVE TREATMENT FOR MALIGNANT LIVER HILAR OBSTRUCTION

作　　者：卢晓明[1] 周友生[1] 陈道达[1] 

机构地区：[1]同济医科大学附属协和医院普外科,430022

出　　处：《中国普通外科杂志》1996年第1期21-22,25-64,共4页China Journal of General Surgery

摘　　要：肝门部胆管恶性梗阻的治疗仍然十分困难。若不解除胆道梗阻,病人很快因肝细胞功能衰竭而死亡。由于肿瘤在肝门部侵润性生长,直接经肝门的手术往往不可能实现。1980～1993年间,我们采用第Ⅲ段肝管空肠吻合术姑息治疗28例肝门部胆管恶性梗阻的黄疸病人。24例为肝门部胆管癌,2例为胆囊癌,2例为胃癌肝门部淋巴结转移。术后19例病人恢复顺利;5例发生并发症,4例病人手术后死亡。24例存活病人中,19例黄疸完全消退3月以上,手术有效率为79％。4例黄疸再次出现,2例因胆管炎需要入院治疗。作者认为:第Ⅲ段肝管空肠吻合术能有效解除不能切除的肝门部恶性肿瘤病人的胆道梗阻。From 1980 to 1993, 28 patients with obstructiove jaundice due to malignancy at the liver hilum were treated by Roux-en-y typy segment III hepatic cholangiojejunostomy. Among them, twenty-four patients had hilar cholangiocarcinoma, two carcinomas of the gallbladder, two recurrent gastric carcinomas. Nineteen patients had no complications, five had complications postoper-atively. There were four postoperative deaths. Nineteen of the 24 surviving patients experienced complete resolutionl of jaundice for at least 3 months after operation, but four developed recurrent jaundice and two had episodes of cholangitis before death. Segment III hepatic cholangiojejunostomy offers effective palliation for most patients with irresectable hilar malignancy.

关 键 词：恶性梗阻 肝门部 肝管空肠吻合 

分 类 号：R657.3[医药卫生—外科学]