胆肠盆式Roux-en-Y吻合术在肝门部胆管良性狭窄中的体会

Experience in basin-formed Roux-en-Y choledochojejunostomy in benign stricture of hilar bile duct

目的探讨肝门部胆管良性狭窄手术中的一种胆肠吻合术式。方法回顾性分析2020年1月—2021年12月在江苏省苏北人民医院治疗肝门部胆管良性狭窄的5例患者的临床资料,随访观察肝功能变化、术后并发症及结石清除情况。结果手术均顺利完成,5例患者中4 b段切除3例,4 b+5段切除1例,未切除肝段1例。术后2周肝功能指标明显下降,发生胆管炎并发切口感染、结石残留1例,切口感染1例,结石残留1例,远期残石率1/5,未出现明显临床症状。结论胆肠盆式Roux-en-Y吻合安全可行,能建立通畅的胆汁引流道,减少胆道结石复发。

Objective To investigate a bilioenterostomy method for the treatment of benign stricture of hilar bile duct.Methods The clinical data of 5 patients with benign stricture of hilar bile duct treated in Northern Jiangsu People's Hospital from January 2020 to December 2021 were enrolled,and the changes of liver function,postoperative complications and clearance of bile duct stones were observed.Results All operations were successfully completed.Among the 5 patients,3 cases had 4 b segment resection,1 case had 4 b+5 segment resection and 1 case had unresected liver segment.The liver function indexes decreased significantly 2 weeks after surgery.1 case had cholangitis complicated with incision infection and residual stone,1 case had incisional infection,and stone residue occurred in 1 case.The long-term residual stone rate was one in fifth and there were no significant clinical symptoms during the follow-up period.Conclusion Basin-formed bilioenterostomy can establish a smooth bile drainage channel,and reduce the recurrence of biliary stones,which is safe and feasible.