Li Yong, Cai Jun, Wu An-Tao, Wang Zi-Jian
Department of General Surgery, First Affiliated Hospital of Jiangxi Medical College, Nanchang 330006, China.
Hepatobiliary Pancreat Dis Int. 2005 Feb;4(1):64-7.
Hepatocholangioplasty combined with choledochostomy was designed through an isolated jejunum passage in 1988. This study was undertaken to evaluate its long-term curative effects in 163 patients.
The 163 patients with hepatolithiasis complicated by stricture were treated with this procedure from 1988 to 2003.
Among these patients, 19 patients with postoperative hepatolithiasis complicated by acute cholangitis were treated successfully with percutaneous paracentesis drainage through the isolated jejunum passage and without operation, 36 patients had postoperative residual or recurrent stones (35 patients had stones removed through the stoma and one underwent relaparotomy because of stenosis of the common bile duct along with stone in canceration). The clearance rate of stones after the isolated jejunum passage was 97%; 35 patients (21%) complicated with stricture due to hepatolith were treated with combined hepatocholangioplasty and choledochostomy. Follow-up for 1 to 15 years showed no recurrent stricture of the biliary tract. The operation also successfully prevented reflux cholangitis and other serious complications after Roux-en-Y cholangio-jejunostomy.
Hepatocholangioplasty combined with choledochostomy through an isolated jejunum passage may significantly improve the long-term curative effects of hepatolithiasis with stricture.
肝内胆管成形术联合胆总管造口术于1988年通过孤立空肠通道设计而成。本研究旨在评估其对163例患者的长期疗效。
1988年至2003年，163例肝内胆管结石合并狭窄患者接受了该手术治疗。
这些患者中，19例术后肝内胆管结石合并急性胆管炎患者通过孤立空肠通道经皮穿刺引流成功治愈，无需手术；36例患者术后有残留或复发性结石（35例患者通过造口取出结石，1例因胆总管狭窄伴癌变结石而行再次剖腹手术）。孤立空肠通道后结石清除率为97%；35例（21%）肝内胆管结石合并狭窄患者接受了肝内胆管成形术联合胆总管造口术治疗。随访1至15年，未见胆道复发狭窄。该手术还成功预防了Roux-en-Y胆管空肠吻合术后的反流性胆管炎及其他严重并发症。
通过孤立空肠通道进行肝内胆管成形术联合胆总管造口术可显著提高肝内胆管结石合并狭窄的长期疗效。
