完全腹腔镜下置管体外桥接引流治疗低位肿瘤梗阻性黄疸并十二指肠梗阻临床观察  

Total Laparoscopic Tube Placement for Extracorporal Bridging in Treatment of Distal Bile Duct Tumorous Obstructive Jaundice Complicated by Duodenal Obstruction

作　　者：苗建军[1] 尚培中[1] 李晓武[1] 张晶[1] 王金[1] 任成云[1] 刘春格[1] 

机构地区：[1]解放军251医院普通外科,河北张家口075000

出　　处：《解放军医药杂志》2014年第2期59-61,64,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨完全腹腔镜下置管体外桥接引流治疗低位肿瘤梗阻性黄疸并十二指肠梗阻的可行性及安全性。方法对解放军251医院2008年5月一2013年8月收治的12例低位肿瘤梗阻性黄疸并十二指肠梗阻在完全腹腔镜下先施行胆总管内放置T形管引流，再施行空肠置管造瘘术，术后2～3周于体外将T形管和空肠造瘘管架桥对接，回输胆汁。结果本组均在完全腹腔镜下成功置管，手术时间47—80min，出血量20～50ml，无一例中转开腹，未发生早期脱管及腹膜炎；平均存活时间7个月。结论对合并十二指肠梗阻的低位肿瘤梗阻性黄疸患者，施行完全腹腔镜下置管体外桥接引流术安全可行。Objective To investigate the feasibility and safety of total laparoscopie tube placement for extracor- poral bridging in treatment of distal bile duct tumorous obstructive jaundice complicated by duodenal obstruction. Meth- ods Twelve patients with distal bile duct tumorous obstructive jaundice complicated by duodenal obstruction during May 2008 and August 2013 in 251 hospital of PLA underwent total laparoscopic catheter nutritional jejunostomy after T-shaped tube drainage, and T-shaped tube and jejunostomy bridge were connected in vitro after postoperative 2-3 weeks for bile re- infusion. Results Total laparoscopie T-shaped tube and catheter nutritional jejunostomy were successfully imbeded with- out transferring to open surgery, complications of early catheter dislodgement and peritonitis in all patients, and the opera- tion time was 47-80 min, the volume of bleeding was 20-50 ml. The average survival duration was 7 months. Conclusion The method of total laparoscopic tube placement for extracorporal bridging in treatment of distal bile duct tumorous ob- structive jaundice complicated by duodenal obstruction is feasible and safe.

关 键 词：肿瘤 黄疸 阻塞性 腹腔镜 胆道外科手术 引流术 

分 类 号：R657.4[医药卫生—外科学]