肝门胆管重建在治疗肝门胆管狭窄中的应用及治疗效果  

Application and efficacy of hilar bile duct reconstruction in the treatment of hilar biliary stenosis

作　　者：文君[1] 张抒[1] 蒲光春[1] 彭秋生[1] 肖渝清[1] Wen Jun;Zhang Shu;Pu Guangchun;Peng Qiusheng;Xiao Yuqing(General Surgery, No.3 People's Hospital of Chengdu, Chengdu Sichuan 610031,china)

机构地区：[1]成都市第三人民医院普外科,四川成都610031

出　　处：《医药前沿》2019年第27期13-14,共2页Journal of Frontiers of Medicine

摘　　要：目的:探讨肝门胆管重建在治疗肝门胆管狭窄中的应用及治疗效果.方法:分析我院2013年11月-2018年6月收治肝门胆管狭窄手术治疗患者45例.按照治疗方式分为,吻合手术组,采取胆管空肠Roux-en-Y吻合手术方式和重建手术组,则采取带血管蒂胆囊瓣重建肝门胆管.比较两组治疗效果.结果:重建手术组手术指标优于吻合手术组,差异显著(P<0.05);治疗后简化36医疗结局研究量表(MOSSF-36)评分重建手术组优于吻合手术组,差异显著(P<0.05).重建手术组术后胆漏发生率显著低于吻合手术组,差异显著(P<0.05).结论:带血管蒂胆囊瓣肝门胆管重建手术治疗肝门胆管狭窄具有较好临床疗效,可简化手术、减少术后并发症,缩短住院时间,改善患者生存质量.Objective To investigate the application and efficacy of hilar bile duct reconstruction in the treatment of hilar biliary stenosis. Methods Forty-five patients with hilar biliary stenosis from November 2013 to June 2018 were retrospectively analyzed. According to the operative approach, the bile duct jejunum Roux-en-Y anastomosis group was treated by bile duct jejunum Roux-en-Y anastomosis, and the biliary reconstruction with gallbladder flap group was performed biliary reconstruction using gallbladder flap with vascular pedicle. The efficacy was compared. Results The surgical index of the biliary tract reconstruction with gallbladder flap was superior to that of the bile duct jejunum Roux-en-Y anastomosis group, P<0.05. After treatment, in the biliary reconstruction with gallbladder flap group,the score of MOSSF-36 was better than that of the bile duct jejunum Roux-en-Y anastomosis group, P<0.05. The postoperative incidence of bile leakage in the biliary reconstruction group with gallbladder flap was significantly lower than that in the bile duct jejunum Roux-en-Y anastomosis group, P<0.05. Conclusion The biliary reconstruction with vascular pedicled gallbladder flap is effective in the treatment of hilar stenosis, which can simplify surgery and reduce complications, reduce postoperative complications, shorten hospital stay improve the quality of life.

关 键 词：肝门胆管重建 肝门胆管狭窄 疗效 

分 类 号：R575[医药卫生—消化系统]