Zhang Yuxin, Zhao Jianping, Chai Songshan, Zhang Zhanguo, Zhang Lei, Zhang Wanguang
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, Hubei province, China.
BMC Surg. 2019 Nov 21;19(1):176. doi: 10.1186/s12893-019-0642-1.
This study aimed to propose a novel surgical reconstruction technique for complex high-location bile duct injury (CHBDI).
There were eight patients with CHBDI underwent the novel hepaticojejunostomy between Feb 2015 and Feb 2017. Seven patients underwent a primary operation and found CHBDI postoperatively in the inferior hospitals referred to our center. And four of them had received hepaticojejunostomy, but the results were not satisfying. One patient (No.8) with radiographically diagnosed hilar cholangiocarcinoma came to our center for surgical treatment and underwent the novel hepaticojejunostomy technique because CHBDI was found in operation. Perioperative and follow-up data of these patients were retrospectively reviewed.
The mean age was 47.6 ± 10.7 years, and there was four female. The mean range of time between the injury and the repair operation in our center was 6.3 ± 4.8 months. All repair operations using the novel hepaticojejunostomy technique in our center were successfully performed. No postoperative complications, including biliary fistula, restenosis, peritonitis, and postoperative cholangitis was observed. Besides, no evidence of biliary stenosis or biliary complications happened during the follow-up (median 28 months).
The novel hepaticojejunostomy is a reliable and convenient technique for surgical repair of multiple biliary ductal openings like CHBDI.
本研究旨在提出一种针对复杂高位胆管损伤（CHBDI）的新型手术重建技术。
2015年2月至2017年2月期间，8例CHBDI患者接受了新型肝空肠吻合术。7例患者接受了初次手术，术后在下级医院发现CHBDI后转诊至我院。其中4例患者已接受过肝空肠吻合术，但效果不佳。1例（8号）经影像学诊断为肝门部胆管癌的患者因术中发现CHBDI而到我院接受手术治疗，并采用了新型肝空肠吻合术。对这些患者的围手术期和随访数据进行了回顾性分析。
患者平均年龄为47.6±10.7岁，女性4例。我院损伤至修复手术的平均时间间隔为6.3±4.8个月。我院所有采用新型肝空肠吻合术的修复手术均成功完成。未观察到术后并发症，包括胆瘘、再狭窄、腹膜炎和术后胆管炎。此外，随访期间（中位时间28个月）未发现胆管狭窄或胆道并发症的迹象。
新型肝空肠吻合术是一种可靠且简便的技术，可用于手术修复如CHBDI这样的多个胆管开口。
