胆肠Roux-en-Y吻合术后桥袢结石的临床诊治  

Diagnosis and treatment of intestinal loop stones after Roux-en-Y cholangiojejunostomy

作　　者：周卫 尹新民[1] 何翔宇 成伟[1] 周杰[1] 刘毅[1] ZHOU Wei;YIN Xinmin;HE Xiangyu;CHENG Wei;ZHOU Jie;LIU Yi(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hunan Normal University,Hunan provincial people’s Hospital,Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院/湖南省人民医院肝胆外科,湖南长沙410005

出　　处：《肝胆胰外科杂志》2022年第3期170-173,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：湖南省自然科学基金项目(2018JJ6015);湖南省肝胆胰肠诊疗能力提升项目(湘卫[2019]118号)。

摘　　要：目的总结胆肠Roux-en-Y吻合术后桥袢结石的诊治体会。方法回顾性分析湖南省人民医院2020年1月至2021年6月4例经腹腔镜再手术治疗桥袢结石患者的临床资料。结果所有患者均在腹腔镜下完成手术,无中转开腹病例。3例行桥袢切开取石术,1例行胆肠吻合口重建术。手术平均时间为(280.7±15.5)min,术中平均出血量(112.5±31.4)mL,术后平均住院时间(8.3±0.4)d,术后平均肛门排气时间(2.5±1.2)d,术后无并发症发生。结论结合临床症状及影像学检查,对胆肠Roux-en-Y吻合术后桥袢结石的诊断有一定的帮助,腹腔镜下桥袢切开取出结石、重建胆肠吻合口并未增加患者住院时间及术后并发症,是安全可行的。Objective To summarize the experience of diagnosis and treatment of intestinal loop stones after Roux-en-Y cholangiojejunostomy.Methods Clinical data of 4 patients with intestinal loop stone who underwent reoperation by laparoscopic surgery in Hunan Provincial People’s Hospital from Jan.2020 to Jun.2021 were retrospectively analyzed.Results All cases underwent laparoscopic surgery,there was no conversion to laparotomy.Among 4 cases,3 underwent stones extraction by incision of intestinal loop,1 case underwent reconstruction of biliary enterostomy.The mean operation time was(280.7±15.5)min,the mean intraoperative bleeding volume was(112.5±31.4)mL,the mean postoperative hospitalization time was(8.3±0.4)d,and the mean time of postoperative gastrointestinal function recovery was(2.5±1.2)d,and no postoperative complication occurred.Conclusion Combined with clinical symptoms and imaging examinations,which is helpful for the diagnosis of intestinal loop stones after Roux-en-Y cholangiojejunostomy.Laparoscopic intestinal loop incision to remove stones and reconstruction of biliary enterostomy,does not increase the hospitalization time and postoperative complications,which is safe and feasible.

关 键 词：胆肠ROUX-EN-Y吻合术 桥袢结石 腹腔镜手术 再手术 

分 类 号：R656.4[医药卫生—外科学] R657.7[医药卫生—临床医学]