Lygidakis N J
Arch Surg. 1982 Apr;117(4):481-4. doi: 10.1001/archsurg.1982.01380280065013.
One hundred sixteen cases if postcholecystectomy choledocholithiasis were assessed after different methods of surgical approach. The evidence that previous surgery, advanced age, and long history of symptoms are associated with a high incidence of bile infection and with advanced histological changes in the biliary ductal apparatus was considered as an index of biliary stasis. It is for these patients that a drainage procedure supplementary to choledochotomy was thought to be warranted. Both choledochoduodenostomy and sphincteroplasty were carried out in this series of patients as drainage procedures supplementary to choledochotomy. Choledochoduodenostomy appears to offer a definitive solution to this problem, and it has been shown to be safe and simple to carry out without mortality and with a very low morbidity.
对116例胆囊切除术后胆总管结石患者采用不同手术入路方法进行了评估。既往手术史、高龄以及症状持续时间长与胆汁感染发生率高和胆管系统组织学改变进展相关，这一证据被视为胆汁淤积的指标。正是针对这些患者，人们认为有必要在胆总管切开术之外辅以引流手术。在这组患者中，胆总管十二指肠吻合术和括约肌成形术均作为胆总管切开术的辅助引流手术实施。胆总管十二指肠吻合术似乎为这一问题提供了一种确定性解决方案，而且已证明其实施安全、简单，无死亡病例，发病率极低。
