Galperin E I, Kuzovlev N F
Khirurgiia (Mosk). 1995 Jan(1):26-31.
The article deals with experience in the treatment of 187 patients (in 1980-1992) with cicatricial stricture of the hepatic ducts in the region of their coalescence (0 stricture). A high cholecystoenteric anastomosis, was formed, on a transhepatic drain in 117 (group I) and a precision anastomosis in 70 patients (group II). Analysis of the results of the operations showed that in group I patients, the early postoperative period was quite severe with the development of specific complications due to use of a replaceable transhepatic drain (hematobilia, leakage of bile into the subdiaphragmatic space, subdiaphragmatic abscess). Ten patients died (8.5%), a recurrent stricture was encountered in 4 patients. In group II patients, the early postoperative period followed a favorable course, there were no fatal outcomes, only one patient had a recurrent stricture. Experience shows that a high precision cholecystoenteric anastomosis can be formed in cicatricial stricture of the hepatic ducts in the region of their coalescence by means of some methodical manipulations. However, it should not be considered an alternative to operations with framed drainage of the bile-draining anastomosis.
本文探讨了1980年至1992年间对187例肝管汇合处瘢痕性狭窄（0级狭窄）患者的治疗经验。在117例患者（第一组）中，通过经肝引流形成了高位胆囊肠吻合术，70例患者（第二组）进行了精确吻合术。手术结果分析表明，第一组患者术后早期情况相当严重，因使用可更换的经肝引流管出现了特定并发症（胆道出血、胆汁漏入膈下间隙、膈下脓肿）。10例患者死亡（8.5%），4例出现复发性狭窄。第二组患者术后早期情况良好，无死亡病例，仅1例患者出现复发性狭窄。经验表明，通过一些系统性操作，在肝管汇合处瘢痕性狭窄时可形成高精度胆囊肠吻合术。然而，不应将其视为胆汁引流吻合术框架引流手术的替代方法。
