利用自体带蒂组织瓣修复手术后胆管狭窄

Long-term results after surgical repair of benign biliary stricture by pedicle flap of autogenous tissues

目的评价利用自体带蒂胆囊瓣、胃瓣和空肠瓣修复治疗手术后胆管狭窄的长期疗效。方法对从1992年11月至1995年5月,利用自体带蒂组织瓣修复治疗的4例手术后胆管狭窄病人进行了总结。男女各2例,年龄37～69岁,平均48岁。胆管狭窄Ⅱ型和Ⅲ型各2例。用自体带蒂胆囊瓣、胃小弯前壁胃瓣和空肠瓣分别修复治疗1例、2例和3例。结果无手术死亡和并发症。4例均随访,随访时间为33～63个月。平匀50.5个月。无明显症状,长期疗效佳。结论利用自体带蒂胆囊胆瓣、胃瓣和空肠瓣修复胆管,保留和利用胆管下端 Oddi 氏括约肌功能,是治疗良性胆管狭窄的有效方法。尚需较多的病例积累以对其疗效作进一步的准确评价。

Objective To evaluate the long-term outcome of patients with benign biliary stricture after surgical management by pedicle flap of gallbladder,gastric wall and jejunum.Methods Four pa- tients (two male and two female) undergoing surgical repair of iatrogenic bilary stricture between Nov. 1992 and May 1995 were reviewed retrospectively.The mean age was 48 (ranged from 37 to 69) years. Of them 2 cases were type Ⅱ and 2 cases type Ⅲ.The patients were repaired by pedicle flap of gallblad- der (1 case),gastric wall (2 cases) and jejunum (1 case).Results No operative mortality and morbid- ity occurred.The follow-up rate was 100% and the mean follow-up time was 50.5 months (ranged from 33 to 63).4 cases had no symptoms and the results were satisfied.Conclusions Surgical repairs by pedicle flap of gallbladder,gastric wall and jejunum with preservation of the function of the sphincter of Oddi were effective methods for benign biliary stricture.More cases are needed to further evaluate the long-term results in greater depth.