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腹腔镜肝空肠吻合术治疗良性胆管狭窄:印度一家三级医疗中心的16例病例系列

Laparoscopic hepaticojejunostomy for benign biliary stricture: A case series of 16 patients at a tertiary care centre in India.

作者信息

Sahoo Manash Ranjan, Ali Manwar Sheikh, Sarthak Siddhant, Nayak Jyotirmay

机构信息

Department of Surgery, AIIMS, Bhubaneswar, Odisha, India.

Department of General Surgery, AIIMS, Bhubaneswar, Odisha, India.

出版信息

J Minim Access Surg. 2022 Jan-Mar;18(1):20-24. doi: 10.4103/jmas.JMAS_223_20.

Abstract

BACKGROUND

Gallstone disease is common in India, and since primary management involves surgery, it is one of the most commonly performed surgeries by a general surgeon either laparoscopically or open. There are various factors which are responsible for intra- and post-operative complications. These factors result in significant injuries which cause serious post-operative complications. Amongst them, benign biliary stricture is one such significant complication which is primarily managed by open surgery, but since advent of laparoscopy, there has been an increased interest in doing this repair laparoscopically.

MATERIALS AND METHODS

This is a retrospective study of 16 patients having obstructive jaundice due to benign biliary stricture on magnetic resonance cholangiopancreatography who were operated consecutively over the past 10 years laparoscopically and underwent laparoscopic Roux-en-Y hepaticojejunostomy.

RESULTS

All patients underwent laparoscopic hepaticojejunostomy. The mean surgical time was 280 min, and the mean blood loss was 176 ml. In the post-operative period, most of the patients were started orally after 48 h; four had atelectasis, eight had surgical site infection, none had seroma and two had bile leak. All post-operative complications responded to conservative management.

CONCLUSION

The study demonstrates that laparoscopic surgery for benign biliary strictures is safe and feasible with acceptable results.

摘要

背景

胆结石疾病在印度很常见,由于主要治疗方法是手术,它是普通外科医生最常进行的手术之一,无论是腹腔镜手术还是开放手术。有多种因素可导致术中及术后并发症。这些因素会造成严重损伤,引发严重的术后并发症。其中,良性胆管狭窄就是这样一种重要并发症,其主要通过开放手术治疗,但自腹腔镜技术出现以来,人们对腹腔镜修复该疾病的兴趣日益增加。

材料与方法

这是一项回顾性研究,研究对象为16例因良性胆管狭窄在磁共振胰胆管造影检查中出现梗阻性黄疸的患者,他们在过去10年中连续接受了腹腔镜手术,并进行了腹腔镜Roux-en-Y肝空肠吻合术。

结果

所有患者均接受了腹腔镜肝空肠吻合术。平均手术时间为280分钟,平均失血量为176毫升。术后,大多数患者在48小时后开始经口进食;4例发生肺不张,8例发生手术部位感染,无患者发生血清肿,2例发生胆漏。所有术后并发症均通过保守治疗得到缓解。

结论

该研究表明,腹腔镜手术治疗良性胆管狭窄是安全可行的,结果令人满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94f2/8830584/efe54109c283/JMAS-18-20-g001.jpg

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