重症急性胆管炎急症手术中胆总管末端狭窄的处理(附37例分析)

Treatment of choledochal strictured end in emergency operation of ACST

目的探讨急诊手术中胆总管末端狭窄的手术方法。方法回顾性分析553例急诊胆总管切开探查术中并发胆总管末端狭窄37例的临床资料。结果 37例中行胆总管十二指肠吻合术29例;Oddi's 括约肌切开成形术3例;单纯 T 管引流5例。随访27例,随访率75.7%,疗效满意。结论胆总管十二指肠吻合术及 Oddi's 括约肌成形术是治疗胆总管末端良性狭窄的良好术式,但各有利弊,而胆总管十二指肠吻合术更适于急诊手术及基层医院开展。严格掌握其适应症及手术原则是减少术后并发症的关键。

Objective Study the operation methods of treatment of choledochal strictured end inside of emergency call surgical operation.Methods A retrospective analysis was performed on 553 cases of ACST operations with37 cases of choledochal strictured end.Results Among 37 cases there were 29 cases with choledochoduodenostomy;3 cases with Oddi s sphincteroplasty;choledochotomy T tube drainage 5 cases.Investigate 28 cases,investigatory rate75.5%,curative effect satisfyingly.Conclusion Choledo choduodenostomy and oddi's sphincteroplasty are better methods for treatment of choledo chalstrictured end,But there are pros and cons either of them,choledochoduodenostomy is more fitter for emergency call sucgical operation and grassroot hospitals by comparison.Strictly control its indication and surgical operation principle is the key to reduce operative complications.