胆肠吻合方式的合理选择和技术要点  

Rational selection and technical points of bflioenterostomy

作　　者：姜洪池[1] 谷明旗 

机构地区：[1]哈尔滨医科大学附属第一医院普通外科,150001

出　　处：《中华消化外科杂志》2017年第4期345-348,共4页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金（81270527）;美国中华医学基金会项目（08-894）

摘　　要：胆肠吻合术是消化外科常用手术，其有多种手术方式。尽管各种手术方式各有优缺点，但目前基本形成了以胆肠Roux—en—Y吻合术为主导、其他手术方式相互补充的格局。随着对胆肠吻合术并发症认识的加深，临床上衍生出一些改进方法．且随着科技发展，各种新设备和技术也不断被用于胆肠吻合术。尽管在很多具体问题上还存在争议，但就胆肠吻合方式的合理选择，笔者认为应遵循“目的明确、选择正确、效果确切”原则。即首先在大方向上正确决定胆肠吻合术应用与否，以及恰当选择最适合患者的手术方式，最后是避免技术失误、保证手术效果确切。Bilioenterostomy with a wide variety of tech- niques is a common surgical operation in digestive surgery. Each of these surgeries has its own advantages and disadvantages. At present, Roux-en-Y eholedoehojejunostomy seems to be the dominant surgery, while other operations are used in some particular circumstances. Furthermore, some modified surgeries for bilioenterostomy have been conducted with the deepening understanding of the complications. Additionally, different kinds of new facilities and techniques have been applied to bilioenterostomy. Despite the controversy on specific issues, reasonable choice of bilioenterostomy should follow the principles of specific purpose, correct choice and reliable effect. In other words, whether or not using bilioenterostomy should be considered correctly from the whole system, and then surgical methods should be accurately chose for patients, and finally avoiding the technical errors and guaranteeing the surgical effects.

关 键 词：胆道疾病 胆肠吻合术 胆肠Roux—en—Y吻合术 

分 类 号：R657.4[医药卫生—外科学]