Maurer C A, Dyong T, Baer H U
Universitätsklinik für Viszerale und Transplantationschirurgie, Inselspital, Bern.
Chirurg. 1995 Aug;66(8):794-9.
Between 1987 and 1992 unilateral, segmental bilioenteric bypass-procedures (30 round ligament approach procedures, 4 peripheral bypass-procedures to the segment III bile duct and 3 to the segment V bile duct) were carried out in 37 icteric patients (twenty cholangio-carcinomas, 8 gallbladder-carcinomas, 6 other malignomas, 3 benign strictures). Postoperative complications were seen in 17 (46%) patients. The 30 day mortality rate was 3% (1/37). Relief of symptoms were achieved in 83% of patients. Objectively there was a significant postoperative reduction of serum bilirubin levels from mean 323 mumol/l to 109 mumol/(p < 0.005) and of the alkaline phosphatase from 708 U/l to 336 U/l (p < 0.005) respectively. This was achieved irrespectively of whether the segmental bypass was draining a segment only or the whole liver. Unilateral segmental bilioenteric bypass-procedures achieve an effective palliation in the majority of patients.
1987年至1992年间，对37例黄疸患者（20例胆管癌、8例胆囊癌、6例其他恶性肿瘤、3例良性狭窄）实施了单侧节段性胆肠旁路手术（30例经圆韧带入路手术、4例至Ⅲ段胆管的外周旁路手术、3例至Ⅴ段胆管的外周旁路手术）。17例（46%）患者出现术后并发症。30天死亡率为3%（1/37）。83%的患者症状得到缓解。客观上，术后血清胆红素水平从平均323μmol/L显著降至109μmol/L（p<0.005），碱性磷酸酶从708 U/L降至336 U/L（p<0.005）。无论节段性旁路是仅引流一个节段还是整个肝脏，均能实现这一效果。单侧节段性胆肠旁路手术在大多数患者中实现了有效的姑息治疗。
