Mihmanli M, Isgör A, Erzurumlu K, Kabukcuoglu F, Mihmalli I
Department of Surgery and Hystopatology, Istanbul Sisli Etfal Training Hospital.
Hepatogastroenterology. 1996 Nov-Dec;43(12):1480-3.
BACKGROUND/AIMS: In this study, gastric mucosal changes and the other clinical results of patients with choledochoduodenostomy (CDD) and T-tube drainage (TTD) were compared in a follow up period of at least 5 years.
The previous files of these patients were evaluated, physical examination and abdominal ultrasonography (US) and gastroscopic examination were made. Esophagus, stomach and the first two parts of the duodenum and size of the anastomosis in patients with choledochoduodenostomy were examined during gastroscopy. Two biopsies from antrum and corpus of the stomach were taken and sections stained with Hematoxylin and eosin for histopathological examination under light microscope.
In total 45 patients, 21 of them with TTD and 24 of them with CDD, were accepted for the study. No difference was present between the mean age, female/male ratio, and interval between the operation date and endoscopic control of both groups (p > 0.05). Common bile duct was evidently wide in the CDD group at the first operation (p < 0.05). In the late postoperative clinical classification of the patients, moderate group was predominant, while incidence of alkaline reflux gastritis was obviously high in the CDD group (p < 0.05). No other difference in the results was present between the two groups (p > 0.05).
According to our study long-term results of T-tube drainage is superior over choledo-choduodenostomy.
背景/目的：本研究对胆总管十二指肠吻合术（CDD）和T管引流术（TTD）患者至少5年随访期内的胃黏膜变化及其他临床结果进行了比较。
评估这些患者之前的病历资料，进行体格检查、腹部超声（US）及胃镜检查。胃镜检查时观察胆总管十二指肠吻合术患者的食管、胃、十二指肠的前两部分及吻合口大小。从胃窦和胃体取两块活检组织，切片用苏木精和伊红染色，在光学显微镜下进行组织病理学检查。
共有45例患者纳入本研究，其中21例行TTD，24例行CDD。两组患者的平均年龄、男女比例以及手术日期与内镜检查间隔时间均无差异（p>0.05）。首次手术时CDD组胆总管明显增宽（p<0.05）。在患者术后晚期临床分类中，中度组占主导，而CDD组碱性反流性胃炎的发生率明显较高（p<0.05）。两组结果的其他方面无差异（p>0.05）。
根据我们的研究，T管引流的长期效果优于胆总管十二指肠吻合术。
