经空肠襻内镜处理胆肠吻合后胆道并发症的临床分析  

Clinical analysis on the treatment of biliary complications after bilioenteric anastomosis via jejunal loop endoscopy

作　　者：刘国平[1] 程广明[1] 麻树人[2] 朱闻溪[3] 

机构地区：[1]沈阳军区总医院肝胆外科,沈阳110015 [2]沈阳军区总医院内窥镜科,沈阳110015 [3]中国医科大学高职学院护理教研室,沈阳110001

出　　处：《解放军医学杂志》2011年第12期1326-1328,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的总结经空肠襻内镜处理胆肠吻合后胆道并发症的经验和体会。方法回顾性分析沈阳军区总医院内窥镜科2005年12月-2011年7月9例(共12次)以输胆空肠襻为入路,通过内镜处理胆肠吻合术后胆道并发症的临床资料。结果手术成功率100%(12/12);术中见吻合口狭窄发生率88.9%(8/9);术后胆管炎缓解及无发作者7例,胆红素水平明显下降者6例;胆结石取净率100%(3/3);放置胆道金属支架2例,塑料支架5例,鼻胆管2例;术后肠瘘1例,肝脓肿1例,切口感染3例。结论经空肠襻内镜处理胆肠吻合后胆道并发症是一项切实有效的微创方法,值得在临床上推广应用。Objective The present study summarizes the treatment of biliary complications after bilioenteric anastomosis via jejunal loop endoscopy.Methods The clinical data of nine cases（12 times） of biliary complications after bilioenteric anastomosis were retrospectively analyzed.The patients were admitted to the Endoscopy Department of the General Hospital of the Shenyang Military Area from December 2005 to July 2011 and were treated via jejunal loop endoscopy.Results The success probability of the operation was 100%（12/12）,and the incidence rate of anastomotic stenosis during operation was 88.9%（8/9）.Seven cases experienced alleviation or no recurrence of reflux cholangitis after the operation.Bilirubin decreased significantly in six cases,and the stone clearance rate was 100%（3/3）.Biliary metal stents were implanted in two cases,plastic stents were employed in five,and naso-biliary tubes were used in the other two.After operation,intestinal fistula occurred in one case,liver abscess occurred in another,and incision infection occurred in three other cases.Conclusion Jejunal loop endoscopy is a highly effective and minimally invasive treatment for biliary complications after bilioenteric anastomosis and,thus,should be widely applied in clinical practice.

关 键 词：空肠 内窥镜 胆管肠吻合术 肝 

分 类 号：R575.7[医药卫生—消化系统]