32例胆总管末端良性狭窄的诊治体会

Experience in Diagnosis and Treatment of Benign Stenosis at the end of Common Bile Duct

目的为提高对胆总管末端良性狭窄的认识,做出正确诊断和治疗。方法回顾性分析我院1983年以来收治的32例胆总管末端良性狭窄的临床诊治资料,胆囊切除术后7例,胆囊切除并胆道探查术后19例,胆源性胰腺炎术后3例,慢性胰腺炎3例。作肝胰壶腹括约肌切开成形术7例,胆肠内引流术14例,内窥镜下括约肌切开术(EST)8例,3例拒绝手术。结果术后并发胆漏1例,十二指肠漏1例。治愈28例,死亡1例。手术效果满意。结论临床医生应提高对胆总管末端良性狭窄的认识。

Objective To improve the understanding of benign stenosis at the end of common bile duct for correct diagnosis and treatment.Methods The clinical data of 32 cases of benign stenosis at the end of common bile duct that were treated in our hospital since 1983 were retrospectively analyzed. 7 patients had a history of cholcystectomy and 19 with a history of cholecystectomy plus choledocholithotomy.3 operations due to biliary pancreatitis, and other 3 cases due to chronic pancreatitis. Seven patients underwent transduodenal sphincterplasty (TDSP), and biliary-jejunal internaldrainage to 14. Eight patients underwent endoscopic papillosphincterotomy (EST).Results After the operation, transient bile leakage was found in2, duodenal fistula was found in 1. Twenty-eight patients were cured and 1 died. The operation result was excellent.Conclusions Doctors should improve the understanding of benign stenosis at the end of common bile duct.