胆总管十二指肠低位大口径吻合术治疗老年复发性胆总管结石患者的临床效果  

Clinical effect of low position large caliber choledochoduodenostomy in the treatment of elderly patients with recurrent choledocholithiasis

作　　者：毕洁亮[1] 孙运璇 刘松山 孙铁柱 BI Jie-liang;SUN Yun-xuan;LIU Song-shan;SUN Tie-zhu(Emergency Surgery Department,Weifang Traditional Chinese Hospital,Weifang 261041,China)

机构地区：[1]山东省潍坊市中医院急诊外科,山东潍坊261041

出　　处：《临床医学研究与实践》2020年第17期64-66,共3页Clinical Research and Practice

摘　　要：目的 探讨胆总管十二指肠低位大口径吻合术治疗老年复发性胆总管结石的临床效果.方法 回顾性分析本院采用胆总管十二指肠低位大口径吻合术治疗的78例老年复发性胆总管结石患者的临床资料,其中男31例,女47例;平均(71.8±7.9)岁;既往接受过1次胆道手术者53例,2次及以上者25例.所有患者均实行胆总管十二指肠低位大口径吻合术.观察患者术后恢复情况及并发症发生情况,通过随访了解患者的复发情况.结果 78例患者手术均顺利完成,平均住院时间(13.1±2.3)d;发生近期并发症4例,包括切口脂肪液化1例,切口感染1例,肺部感染2例;73例患者随访1~10年,平均(5.6±3.1)年,随访率93.6%,发生远期并发症4例,包括肠梗阻2例,切口疝1例,反流性胆管炎1例,无结石复发.结论 胆总管十二肠低位大口径吻合术治疗老年复发性胆总管结石,有防止结石再复发、反流性胆管炎发生率低及手术操作简便等优点,值得推广应用.Objective To explore the clinical effect of low position large caliber choledochoduodenostomy in the treatment of elderly patients with recurrent choledocholithiasis.Methods The clinical data of 78 elderly patients with recurrent choledocholithiasis treated by low position large caliber choledochoduodenostomy in our hospital were retrospectively analyzed,including 31 males and 47 females,with an average of(71.8±7.9)years old.In the past,53 patients had received biliary tract surgery once,25 patients had received biliary tract surgery twice or more.All patients underwent low position large caliber choledochoduodenostomy.The postoperative recovery and complications of the patients were observed,and the recurrence of patients was understood through follow-up.Results The operation of 78 patients were completed successfully,and the average hospitalization time was(13.1±2.3)d.Recent complications occurred in 4 patients,including 1 case of incision fat liquefaction,1 case of incision infection and 2 cases of pulmonary infection.The 73 patients were followed up for 1-10 years,with an average of(5.6±3.1)years,and the follow-up rate was 93.6%.There were 4 cases of long-term complications,including 2 cases of intestinal obstruction,1 case of incisional hernia,1 case of reflux cholangitis,and no stone recurrence.Conclusion Low position large caliber choledochoduodenostomy in the treatment of elderly patients with recurrent choledocholithiasis has the advantages of preventing the recurrence of stone,low incidence of reflux cholangitis and simple operation,which is worth popularizing and applying.

关 键 词：复发性胆总管结石 胆总管十二指肠合术 反流性胆管炎 

分 类 号：R657.4[医药卫生—外科学]