大口奥狄括约肌成形术治疗胆道下端炎性狭窄15例报告

Transduodenal sphincteroplasty of hoof-shaped for benign stricture of terminal common bile duct.

本文报告了15例经十二指肠"马蹄"形大口奥狄括约肌成形术。术前全部病例经B超、同位素检查证实有不同程度的肝内外胆管扩张及胆道下端梗阻。术中常规探查证实诊断后,切开十二指肠。奥狄括约肌切开长度为2.5～3.0cm,切除宽度为0.5～0.8cm。成形完成后为"马蹄"形,直达扩张段胆总管,并可顺利通过8号Bakes扩张器,术后疗效满意.该术式切断长度及范围充分,消除了倒"V"形成形术切断括约肌不充分的缺点,扩大了手术适应证。

Fifteen cases of transduodenal sphincteroplasty of hoof-shaped were presented. Preoperative ultrasonography and scintiphotography showed the dilatation of intra-and extra-hepatic bile duct and obstruction of terminal common bile duct. After routine exploration and confirmation of the lesion, an oblique incision on the duodenal wall was made. The papilla was incised for a length of 2.5-3.0cm and a width of 0.5-0.8cm, so a hoof-shaped opening was formed and No. 8 Bakes dilator passed easily. Postoperative recovery was satisfied. This procedure provided sufficient incision, avoiding the shortcoming of upside-down 'V' shaped sphincteroplasty. Furthermore, it extended indications of the procedure.