Rozhl Chir. 2022 Summer;101(7):332-336. doi: 10.33699/PIS.2022.101.7.332-336.
We present the case of a 60-year-old patient with the history of subtotal gastric resection and reconstruction of passage using the Roux-Y loop, five years later diagnosed with benign stenosis of the common bile duct. The possibilities of using endoscopy and interventional radiology for the bile duct treatment in the postoperatively altered terrain of the proximal digestive tract were limited. After failure of these methods the patient was indicated for surgery - biliodigestive anastomosis. The postoperative course was significantly complicated by bleeding and formation of bile and colic fistulas. Over time, a migrated stent was found in the small intestine, which was the cause of inflammatory changes and incomplete small bowel obstruction. Increased intraluminal pressure in the intestinal loops inhibited healing of the anastomosis and was a major cause of the complications.
我们报告了一例 60 岁患者的病例，该患者五年前因 Roux-Y 袢重建术接受了胃大部切除术，术后诊断为胆总管良性狭窄。由于近端消化道解剖结构改变，内镜和介入放射学治疗的可能性有限。这些方法均失败后，患者行手术治疗-胆肠吻合术。术后出现明显并发症，包括出血、胆瘘和结肠瘘。随着时间的推移，在小肠中发现移位的支架，这是引起炎症改变和不完全性小肠梗阻的原因。肠袢内压力增高抑制吻合口愈合，是导致并发症的主要原因。
