胰十二指肠切除术后胆肠吻合口狭窄的影响因素及治疗  

Treatment of biliary-enteric anastomotic stricture after pancreaticoduodenectomy

作　　者：梅佳玮 翁明哲 束翌俊 王雪峰[1] 龚伟[1] MEI Jia-wei;WENG Ming-zhe;SHU Yi-jun(Department of General Surgery,Xin Hua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai Key Laboratory of Biliary Tract Disease Research,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院普外科、上海市胆道疾病研究重点实验室、上海市胆道疾病研究中心、上海交通大学医学院胆道疾病研究所,上海200092

出　　处：《中国实用外科杂志》2023年第7期819-822,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.82172628,No.81974371,No.82173048);上海市科委科技创新行动计划医学创新研究专项(No.22Y11908000)。

摘　　要：胆肠吻合口狭窄为胰十二指肠切除术后主要远期并发症之一,影响病人远期疗效,应引起足够重视。术前肝总管直径、胆肠吻合口缝合方式、胆肠吻合使用的缝线类型及胆管断端的血供是发生胆肠吻合口狭窄的主要危险因素。首选治疗方式为内镜逆行性胰胆管造影,仅在内镜或经皮介入治疗均失败后才考虑再次手术治疗。高质量完成胆肠吻合重建,是预防胰十二指肠切除术后胆肠吻合口狭窄的关键。Biliary-enteric anastomotic structure is one of the main later complications after pancreaticoduodenectomy,which has a negative impact on the long-term efficacy of PD and should be given sufficient attention.The main risk factors for its occurrence are the diameter of the common hepatic duct before surgery,the suture method of the biliary-enteric anastomosis,the type of suture used for biliary-enteric anastomosis,and the blood supply of the bile duct stump.Endoscopic retrograde cholangiopancreatography is the preferred treatment method,and reoperation is only considered after both endoscopic and percutaneous intervention treatments fail.High quality completion of biliary-enteric anastomosis reconstruction is the key to preventing biliary-enteric anastomotic stricture after pancreaticoduodenectomy.

关 键 词：胰十二指肠切除术 胆肠吻合口狭窄 内镜逆行性胰胆管造影 

分 类 号：R6[医药卫生—外科学]