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肝空肠吻合口狭窄后肝内胆管结石的微创治疗

Minimally invasive treatment of intrahepatic cholangiolithiasis after stricture of hepaticojejunal anastomosis.

作者信息

Varabei Aliaksandr, Arlouski Yury, Lagodich Natalli, Arehay Vitaly

机构信息

Belarusian Medical Academy of Post-Graduate Education, Minsk, Belarus.

N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2018 Mar;13(1):111-115. doi: 10.5114/wiitm.2018.72667. Epub 2018 Jan 10.

DOI:10.5114/wiitm.2018.72667
PMID:29643967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5890845/
Abstract

The aim of the study was to improve the results of treatment of patients with intrahepatic cholangiolithiasis for hepaticojejunostomy stricture with use of miniinvasive methods. In our centre during the period from 2002 till 2016 were treated in 58 patients with hepaticojejunostomy strictures. Thirteen patients from their was coexistant intrahepatic cholangiolithiasis. Forty-six (79.3%) patients was performed rehepaticojejunostomy. Twelve patients was performed a minimally invasive intervention such as laser recanalisation using double balloon enteroscopy (7 patients) and lithoextraction with double balloon enteroscopy (1), transhepatic cholangioscopy (2 patients) with laser lithotripsy (1), balloon dilatation of the stricture rehepaticojejunostomosis (4), lithoextraction (4), including with double balloon enteroscopy ("randevoux" procedure) (1), stenting (2). We observed several complication such as cholangitis (5); recurrent cholangiolithiasis (1); restricture of rehepaticojejunostomosis (2). Miniinvasive endoscopic techniques treatment and endobiliary correction of rehepaticojejunostomosis strictures and cholangiolithiasis have shown good results.

摘要

本研究的目的是利用微创方法改善肝内胆管结石患者肝空肠吻合口狭窄的治疗效果。2002年至2016年期间，我们中心共治疗了58例肝空肠吻合口狭窄患者。其中13例患者合并肝内胆管结石。46例（79.3%）患者接受了再次肝空肠吻合术。12例患者接受了微创干预，如使用双气囊小肠镜进行激光再通术（7例）、双气囊小肠镜取石术（1例）、经肝胆管镜检查（2例）及激光碎石术（1例）、肝空肠吻合口狭窄气囊扩张术（4例）、取石术（4例，包括双气囊小肠镜“会师”手术（1例））、支架置入术（2例）。我们观察到了几种并发症，如胆管炎（5例）、复发性胆管结石（1例）、肝空肠吻合口再狭窄（2例）。微创内镜技术治疗以及肝空肠吻合口狭窄和胆管结石的胆道内矫正已显示出良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/573101d19d81/WIITM-13-31463-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/5e9b0ca73589/WIITM-13-31463-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/b261811bd74c/WIITM-13-31463-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/7bb8a8a518cd/WIITM-13-31463-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/eb366b6a2d91/WIITM-13-31463-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/f1fc4ca0bf20/WIITM-13-31463-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/573101d19d81/WIITM-13-31463-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/5e9b0ca73589/WIITM-13-31463-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/b261811bd74c/WIITM-13-31463-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/7bb8a8a518cd/WIITM-13-31463-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/eb366b6a2d91/WIITM-13-31463-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/f1fc4ca0bf20/WIITM-13-31463-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bea/5890845/573101d19d81/WIITM-13-31463-g006.jpg

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本文引用的文献

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Multiple plastic stents for benign extrahepatic biliary strictures: report of a case.用于良性肝外胆管狭窄的多个塑料支架：病例报告
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