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[奥迪括约肌切开术或括约肌成形术。关于采用个人括约肌成形术技术所获结果的思考]

[Oddi's sphincterotomy or sphincteroplasty. Considerations on the results obtained with a personal sphincteroplasty technic].

作者信息

Duca S, Badea G, Hurubeanu C, Horvath M, Ionescu D

出版信息

Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1982 Mar-Apr;31(2):131-40.

PMID:6214820
Abstract

A total of 21 cases are presented, of patients in whom Oddian sphincteroplasty was performed, according to an original technique. In 19 cases the indication was due to Oddian stenosis associated to lithiasis or hepatic hydatic cysts which had ruptured in the biliary pathways. In two other cases security sphincteroplasty of the Oddi sphincter was performed for lithiasis of the choledocus. The decision was based on macroscopic changes of the biliary pathways, on the control of the main biliary pathway. Sphincteroplasty was achieved with the aid of an original probe, and the incision of the ampullary area was in the average 25 mm in length. The postoperative control, made by tube cholangiography and barium examination, has evidenced the presence of a wide, open choledocoduodenal orifice. Duodenal fistula was one of the complications which followed duodenostomy. This however was fully repaired in 14 days after conservative treatment. After a confrontation of the results achieved with this method, and the data published in the literature the authors support oddian sphincteroplasty, and stress its advantages by comparison with the results provided by sphincterotomy.

摘要

共报告了21例患者,这些患者均按照一种原创技术接受了奥迪括约肌成形术。19例患者的手术指征是奥迪括约肌狭窄合并结石或肝包虫囊肿破裂进入胆道系统。另外2例患者因胆总管结石接受了奥迪括约肌安全成形术。手术决策基于胆道系统的宏观变化以及对主要胆管通路的控制。借助一种原创探头完成括约肌成形术,壶腹部区域的切口平均长度为25毫米。术后通过胆管造影和钡剂检查进行的对照显示,存在一个宽大、开放的胆总管十二指肠开口。十二指肠瘘是十二指肠造口术后的并发症之一。不过,经过保守治疗,十二指肠瘘在14天内完全愈合。在将该方法取得的结果与文献中公布的数据进行对比后,作者支持奥迪括约肌成形术,并强调与括约肌切开术相比其具有的优势。

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