Choi T K, Fan S T, Lai E C, Wong J
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Surgery. 1988 Sep;104(3):525-9.
Segmental bilioenteric anastomosis procedures were performed on 22 patients with malignant hilar biliary obstructions. The majority of the bypasses were done to the segment 3 duct and a single anastomosis was performed in each patient. The operative mortality rate was 13.6% and morbidity, 27.3%. The biliary obstruction was completely relieved in 5 patients, partially but satisfactorily relieved in 11 patients, and not relieved in 3 patients. The mean survival was 8 months, and the median survival was 6 months. Late complications were seen in 42% of the patients, and these complications included cholangitis, liver failure, and duodenal obstruction. An analysis of the operative results with respect to the presence of right and left ductal system communication showed that when communication was absent, there was a greater incidence of unsuccessful relief of the biliary obstruction. When communication was present, the incidence of late cholangitis that involved the undrained side was greater.
对22例恶性肝门部胆管梗阻患者实施了节段性胆肠吻合术。大多数搭桥手术是针对3段胆管进行的，每位患者均进行了单次吻合。手术死亡率为13.6%，发病率为27.3%。5例患者的胆管梗阻完全缓解，11例患者部分但满意地缓解，3例患者未缓解。平均生存期为8个月，中位生存期为6个月。42%的患者出现晚期并发症，这些并发症包括胆管炎、肝功能衰竭和十二指肠梗阻。对手术结果关于左右胆管系统连通情况的分析表明，当不存在连通时，胆管梗阻缓解失败的发生率更高。当存在连通时，涉及未引流侧的晚期胆管炎发生率更高。
