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腹腔镜改良袢式胆囊空肠吻合术治疗恶性梗阻性黄疸的临床疗效

Clinical efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice.

作者信息

Li Jiaxin, Zhuo Shijie, Chen Binghong, Liu Yang, Wu Hong

机构信息

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

Department of General Surgery, People's Hospital of Zizhong County, Zizhong, Sichuan Province, China.

出版信息

J Int Med Res. 2020 Feb;48(2):300060519866285. doi: 10.1177/0300060519866285. Epub 2019 Sep 23.

Abstract

OBJECTIVE

This study was performed to summarize our experience and investigate the safety and efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice.

METHODS

Thirteen patients with malignant obstructive jaundice who underwent laparoscopic modified loop cholecystojejunostomy from March 2015 to March 2016 were retrospectively reviewed. The patients' characteristics, operation time, postoperative intestinal recovery time, length of hospital stay, postoperative bilirubin level, and complications were analyzed.

RESULTS

The patients were followed up as outpatients for 2 years. Nine patients with pancreatic head carcinoma, one patient with periampullary carcinoma, and three patients with distal bile duct carcinoma successfully underwent laparoscopic modified loop cholecystojejunostomy. The mean operation time was 176 ± 45 minutes, and the mean length of hospital stay was 9.5 ± 2.8 days. The serum total bilirubin concentration and gamma-glutamyl transferase concentration significantly decreased on postoperative day 7. The median follow-up time was 7 months. No patients developed bile leakage or required a reoperation.

CONCLUSIONS

Laparoscopic modified loop cholecystojejunostomy is not only safe and minimally invasive, but it is also feasible for patients with malignant obstructive jaundice.

摘要

目的

本研究旨在总结我们的经验,并探讨腹腔镜改良袢式胆囊空肠吻合术治疗恶性梗阻性黄疸的安全性和有效性。

方法

回顾性分析2015年3月至2016年3月期间接受腹腔镜改良袢式胆囊空肠吻合术的13例恶性梗阻性黄疸患者的资料。分析患者的特征、手术时间、术后肠道恢复时间、住院时间、术后胆红素水平及并发症情况。

结果

患者门诊随访2年。9例胰头癌患者、1例壶腹周围癌患者和3例远端胆管癌患者成功接受了腹腔镜改良袢式胆囊空肠吻合术。平均手术时间为176±45分钟,平均住院时间为9.5±2.8天。术后第7天血清总胆红素浓度和γ-谷氨酰转移酶浓度显著下降。中位随访时间为7个月。无患者发生胆漏或需要再次手术。

结论

腹腔镜改良袢式胆囊空肠吻合术不仅安全、微创,而且对恶性梗阻性黄疸患者也是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aa7/7593670/da0117857da0/10.1177_0300060519866285-fig1.jpg

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