Batvinkov N I, Garelik P V, Koialo I K, Rusin N I
Khirurgiia (Mosk). 1993 Jan(1):17-21.
Bile-diverting operations in 386 patients with obstructive jaundice are analysed. It was caused by benign diseases in 202 patients (group 1) and by malignant tumors of the biliary tract and pancreas in 184 patients (group 2). Laparoscopic cholecystostomy was carried out in the first stage of treatment in each third patient. In patients of group 1 choledocholithotomy was the main operation performed for restoration of the flow of bile, it was combined with external drainage of the biliary tract in 54 patients, supplemented by transduodenal papillosphincterotomy in 30 patients, choledochoduodenostomy was carried out in 30 patients. The flow of bile was restored in group 2 patients by forming biliodigestive anastomoses. The most frequent among them were cholecystojejunostomy (38) and choledochoduodenostomy (31). Laparoscopic cholecystostomy was the most expedient operation in 61 patients with a spreading neoplastic process.
对386例梗阻性黄疸患者的胆汁转流手术进行了分析。其中202例(第1组)由良性疾病引起,184例(第2组)由胆道和胰腺恶性肿瘤引起。每三分之一的患者在治疗第一阶段进行了腹腔镜胆囊造瘘术。在第1组患者中,胆总管切开取石术是恢复胆汁流动的主要手术,54例患者联合了胆道外引流,30例患者辅以经十二指肠乳头括约肌切开术,30例患者进行了胆总管十二指肠吻合术。第2组患者通过形成胆肠吻合术恢复胆汁流动。其中最常见的是胆囊空肠吻合术(38例)和胆总管十二指肠吻合术(31例)。腹腔镜胆囊造瘘术对61例肿瘤扩散患者是最适宜的手术。