皮下通道胆囊肝胆管成形术与胆肠吻合术的中远期并发证比较  

Clinical effects of subcutaneous tunnel and hepatocholangioplsty with the use of gallbladder in the treatment of hepatolithiasis and biliary stenosis

作　　者：王雨[1] 田伏洲[1] 汤礼军[1] 张晓琼[1] 李旭[1] 张炳印[1] 赵铁军[1] 

机构地区：[1]成都军区总医院全军普外中心,成都610083

出　　处：《西南国防医药》2003年第5期484-486,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的 :总结皮下通道型胆囊肝胆管成形术 (STNG)治疗肝胆管结石及胆道狭窄的临床效果。方法 :统计了1994 - 12～ 2 0 0 0 - 0 6期间我科 5 9例行STHG手术患者的适应证及术后中、远期并发证。并选择同期 10 3例行传统胆肠吻合 (CJ)的患者进行对照。结果 :STHG的手术适应证与传统胆肠吻合基本相同 ;STHG并发证总体发生率明显低于CJ组 ,而且并发证的种类也明显少于CJ组 ;STHG组基本无反流性胆管炎的表现 ,而且无胃肠道功能紊乱和吻合口溃疡发生。结论 :该术式既保存了胆囊及Oddi括约肌功能 ,又保证了胆汁的生理流向 ,防止了肠液反流 ,避免了消化功能紊乱 ,防止了反流性胆管炎等并发证 。Objective:To summarize the clinical effects of subcutaneous tunnel and hepatocholangioplasty with the use of gallbladder(STHG)in the treatment of hepatolithiasis and biliary stenosis.Methods:We made a statistics of the indications and complicaions of STHG in 50 paients between 1994 and 2000 and made a comparison with that of traditional choledochojejunostomy(CJ)in 103 patients during the correspondig period.Results:The indications of STHG were similar with that of CJ.Compared with that in CJ group,the complication rate of STHG was significantly lower,especially the rate of reflux cholangitis,disorder of gastrointestinal function and ulces of anastomosis orifce.Conclusion:STHG not only keeps the normal physiological function of gallbladder and oddi's sphincter but also maintains the physiological way of bile fluid and prevents intestinal juice reflux.Therefore,STHG is a satisfactory operation for hepatolithiasis and biliary stenosis.

关 键 词：皮下通道胆囊肝胆管成形术 胆肠吻合术 并发证 肝胆管结石 胆道狭窄 适应证 反流性胆管炎 

分 类 号：R657.4[医药卫生—外科学]