Moreno-González E, Sanmartin J H, Herruzo J A, Azcoita M M
Br J Surg. 1980 Apr;67(4):263-5. doi: 10.1002/bjs.1800670411.
Intrahepatic biliary intestinal diversion for biliary obstruction was performed in 34 patients. Benign strictures were found in 15 patients and malignant disease in 19. Central cholangiojejunostomy was performed on 15 patients with iatrogenic strictures of the hepatic junction and on 2 patients after removal of a common hepatic duct carcinoma. In 14 patients an isolated jejunal loop interposed between the hepatic ducts and duodenum was used. In patients with malignant obstruction of the common hepatic duct peripheral cholangiojejunostomy was performed using the left hepatic duct radicals in 14 patients, a bilateral cholangiojejunostomy in 3 patients and a left cholangiogastrostomy in 2 patients. One patient died on the twenty-first postoperative day. The follow-up of patients with benign disease varied between 5 months and 6 years; all patients were free of symptoms at the time of their last follow-up examination. In patients with malignant disease, the follow-up varied from 6 months to 29 months, 7 patients being still alive 8--29 months after operation. We believe cholangiojejunostomy is the best biliary diversion procedure in obstructions of the common hepatic duct.
对34例胆管梗阻患者实施了肝内胆管肠道转流术。其中15例为良性狭窄，19例为恶性疾病。对15例肝门部医源性狭窄患者及2例肝总管癌切除术后患者实施了中央胆管空肠吻合术。14例患者采用肝管与十二指肠间置入孤立空肠袢的方法。对肝总管恶性梗阻患者，14例采用左肝管根部行外周胆管空肠吻合术，3例采用双侧胆管空肠吻合术，2例采用左胆管胃吻合术。1例患者术后第21天死亡。良性疾病患者的随访时间为5个月至6年；在最后一次随访检查时，所有患者均无症状。恶性疾病患者的随访时间为6个月至29个月，7例患者术后8至29个月仍存活。我们认为胆管空肠吻合术是肝总管梗阻时最佳的胆管转流术式。
