Thomson S R
Department of Surgery, King Edward VIII Hospital, Durban.
S Afr J Surg. 1998 Feb;36(1):26-9.
The case histories of 5 patients who presented with recurrent jaundice following cholecystojejunostomy for biliary decompression of benign intrapancreatic strictures were studied. Four developed episodes of severe cholangitis 2-9 years after their initial operation. A subsequent surgical intervention was undertaken in 3 patients, 2 of whom died from cholangitis. The fourth patient experienced 3 episodes of cholangitis, declined surgical intervention and died. The fifth patient presented 4 months after the first procedure with a transient cholangitis. Cholelithiasis and cholangitis may take several years to develop but seem inevitable when cholecystojejunostomy is used to decompress benign biliary obstruction. Its use in suspected benign biliary obstruction should be abandoned.
对5例因良性胰内胆管狭窄行胆囊空肠吻合术以进行胆道减压后出现复发性黄疸的患者的病历进行了研究。4例在初次手术后2至9年发生严重胆管炎发作。3例患者随后接受了手术干预,其中2例死于胆管炎。第4例患者经历了3次胆管炎发作,拒绝手术干预并死亡。第5例患者在首次手术后4个月出现短暂性胆管炎。胆石症和胆管炎可能需要数年时间才会发展,但当使用胆囊空肠吻合术来解除良性胆道梗阻时似乎是不可避免的。应放弃将其用于疑似良性胆道梗阻的情况。