胆肠吻合术再次手术的原因及诊治方法  

Causes and Treatment Methods of Reoperation after Cholangioenterostomy

作　　者：鲁旭 吴立胜[1,2] 汪宏 

机构地区：[1]安徽医科大学第三附属医院 [2]合肥市第一人民医院综合微创外科,合肥230061

出　　处：《肝胆外科杂志》2014年第1期34-36,共3页Journal of Hepatobiliary Surgery

摘　　要：目的 探讨胆肠吻合术再手术的原因、诊断及处理方法.方法 回顾分析我院从2003年6月～2013年6月53例胆肠吻合术后再次手术患者的临床资料.结果 在53例患者中,胆道囊肿未完全切除5例;吻合口及胆道狭窄46例,其中单纯性胆道狭窄35例,合并吻合口、胆管结石11例,胆管恶性病变（含恶变倾向）2例.53例患者再次手术均以胆管空肠Roux-en-Y吻合术为主,术后恢复良好,症状均得到解决,随访6个月～2年.结论 胆肠吻合术再手术的原因以原发病灶去除不彻底、吻合口及胆道狭窄、初次手术的方式不当为主,处理的原则是“去除病灶、解除梗阻、通畅引流”,胆管空肠Roux-en-Y吻合术是很好的再次手术方式.Objective To investigate the causes and the treatment methods of reoperation after cholangioenterostomy.Methods Retrospectively analyzed 53 cases of reoperation after cholangioenterostomy in our institution between 2003.6 ～ 2013.6.Results In those cases,there are 5 cases of residual choledochal cyst.And there are 46 cases of anastomotic and biliary stricture,which are consisted of simple biliary stricture （35 cases） and biliary stricture with anastomosis or biliary calculi.Bile duct cancer including cancer tendency are in 2 cases.All of these patients underwent a reoperation based on Roux-en-Y choledochojejunostomy.All of 53 patients recovered well during postoperative follow-up for 6 ～ 24 months.Conclusion The causes of reoperation after cholangioenterostomy are mainly composed by residual lesions,anastomotic and biliary stricture,and the improper operation methods.The treatment principle is removing lesions,relieving obstruction and unobstructed drainage.It is a good reoperation method to undergo Roux-en-Y choledochojejunostomy.

关 键 词：胆肠吻合术 再次手术 ROUX-EN-Y 吻合术 

分 类 号：R657.5[医药卫生—外科学]