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良性胆道疾病中胆肠吻合术的评估

Evaluation of biliary enteric anastomosis in benign biliary disorders.

作者信息

Singh Devinder Pal, Arora Sohrab

机构信息

Department of Surgery, Govt. Medical college and Rajindra Hospital, Patiala, 47, Ranjeet Bagh, Passey Road, Patiala, Punjab 147001 India.

Department of Surgery, Govt. Medical college and Rajindra Hospital, Patiala, 47, Ranjeet Bagh, Passey Road, Patiala, Punjab 147001 India ; Govt Medical College, Patiala, 47, Ranjeet Bagh, Passey Road, Patiala, Punjab 147001 India.

出版信息

Indian J Surg. 2014 Jun;76(3):199-203. doi: 10.1007/s12262-012-0648-8. Epub 2012 Jul 13.

Abstract

Evaluation of various methods of biliary enteric anastomosis in benign biliary diseases (BBD). A surgeon operating for BBD needs to improve the internal drainage of bile to prevent stasis and its back-pressure effects. This is best obtained by biliary enteric anastomosis. A total of 121 cases of biliary enteric anastomosis in BBD were included in this study. The postoperative course and long-term outcome were studied prospectively. In the choledochoduodenostomy group, there were no leaks, no restrictures, and no mortality. Five (10.41 %) patients had cholangitis attacks and 2 (4.17 %) patients had sump syndrome. The choledochojejunostomy group had no leaks, no restrictures. Two (7.14 %) patients had repeated cholangitis and 2 (7.14 %) patients had sump syndrome, no mortality. The hepaticojejunostomy group had 3 cases of anastomotic leak of which 2 healed spontaneously and 1 needed resurgery. There was restricture in 2 cases, in which resurgery was successful-one death, no cholangiocarcinoma. Biliary enteric anastomosis is a safe and effective method for the management of BBD. The method should be selected according to the disease pathology and patient characteristics.

摘要

良性胆道疾病(BBD)中各种胆肠吻合方法的评估。进行BBD手术的外科医生需要改善胆汁的内引流,以防止胆汁淤积及其反压效应。这最好通过胆肠吻合术来实现。本研究纳入了121例BBD患者的胆肠吻合术病例。对术后病程和长期预后进行了前瞻性研究。在胆总管十二指肠吻合术组中,无渗漏、无狭窄,无死亡病例。5例(10.41%)患者发生胆管炎发作,2例(4.17%)患者发生残端综合征。胆总管空肠吻合术组无渗漏、无狭窄。2例(7.14%)患者反复发生胆管炎,2例(7.14%)患者发生残端综合征,无死亡病例。肝管空肠吻合术组有3例吻合口漏,其中2例自行愈合,1例需要再次手术。2例发生狭窄,再次手术成功,1例死亡,无胆管癌发生。胆肠吻合术是治疗BBD的一种安全有效的方法。应根据疾病病理和患者特征选择该方法。

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