改良胆肠袢式吻合术治疗小儿胆管扩张症的疗效分析  

The therapeutic effects of modified loop-type(Warren)biliary-enteric anastomosis for children with biliary tract dilatation

作　　者：樊剑锋[1] 石英佐[1] 朱晓敏[1] 浦晓[1] 王达丰[1] 宣晓琪[1] 程明[1] 

机构地区：[1]江苏省无锡市儿童医院儿外科,江苏省无锡市214023

出　　处：《临床小儿外科杂志》2016年第1期26-28,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨改良胆肠袢式(Warren)吻合术重建胆道治疗小儿胆管扩张症的临床疗效。方法回顾性分析2010年1月至2013年9月我们收治的44例胆管扩张症患儿临床资料,其中20例行改良胆肠袢式(Warren)吻合术(改良组),24例行胆管空肠Roux-en-Y吻合术(Roux-Y组)。比较两组手术时间、肠功能恢复时间、肝功能恢复情况及术后并发症情况。结果改良组平均手术时间(63±11)min,Roux-Y组平均手术时间(75±15)min,差异有统计学意义(P<0.05)。改良组术后肠功能恢复时间(21±4)h,Roux-Y组(33±6)h,差异有统计学意义(P<0.05)。两组肝功能恢复情况和退黄效果相同。除Roux-Y组有1例因肠粘连肠梗阻住院保守治疗后缓解外,两组均无返流性胆管炎等并发症。结论改良胆肠袢式吻合术重建胆道治疗小儿胆管扩张症的疗效与Roux-en-Y吻合术相同,但操作简便,术后肠功能恢复快。Objetive To explore the clinical efficacy of a modified biliary-enteric loop type （Warren） anastomosis in treating biliary tract dilatation in children. Methods A retrospective analysis was made on 44 cases of biliary tract dilatation in children underwent surgery from Jan. 2010 to Sep. 2013. Methods loop-type biliary-enteric anastomosis were performed in 20 cases （ test group） and biliary-enteric Roux-en-Y anastomosis in 24 cases （ control group）. The operation time for biliary-enteric anastomosis, patients＂ recovery time, liver function and postoperative complications between the 2 groups were compared. Results Operation time for bil- iary-enteric anastomosis and patients＇recovery time were （63±11 min） and （21±4 h） in test group and （75±15 min） and （ 33±6 h） in control group, with statistical difference between the 2 groups （ P 〈 0. 05 ）. Except 1 case of adhesive intestinal obstruction in control group, there was no significant difference between the two groups in biliary drainage, jaundice elimination, postoperative complications and incidence of re-operation. Conclusions Compared with biliary-ent^ric Roux-en-Y anastomosis ,the modified biliary-enteric （Warren） anastomosis is a simple and reliable operation technique for biliary tract dilatation in children with better shortterm outcomes.

关 键 词：胆总管疾病 吻合术 Roux—en—Y 治疗结果 儿童 

分 类 号：R726.5[医药卫生—儿科]