应用带蒂自体组织修复肝门部胆管狭窄

The repair of porta hepatic duct stricture by pedicled autograft

目的总结应用带蒂自体组织修复肝门部胆管良性狭窄的经验。方法回顾性分析 1989-2003年应用带蒂胆囊壁瓣修复肝门部胆管良性狭窄38例、直用带蒂胃壁片2例及肝圆韧带脐静脉片2例修复肝总管狭窄的临床资料。结果 42例术后无明显胆瘘、出血等并发症。无手术死亡。术后T管造影显示胆道通畅无狭窄。术后随访40例6个月至14年,2例因术后胆管炎发作,经保守治疗治愈。结论应用自体组织带蒂胆囊壁瓣,肝圆韧带脐静脉片及带蒂胃壁片修复肝门部胆管良性狭窄符合生理,取材方便,操作简便,效果良好。

Objective To evaluate the repair of benign constriction of the porta hepatic duct by pedicled autograft. Methods The clinical data of repair by pedicled valve of gallbladder in 38 cases, by pedicled gastric wall in 2 cases and by round ligament of the liver in 2 cases were retrospectively analyzed. Results There were no operative mortality and no complications such as bile leaks and hemorrhage. Cholangiography through T-tube showed patency in all postoperative patients. A follow-up from 6 months to 14 years in 40 out of 42 cases found cholangitis in 2 patients with good response to conservative therapy. Conclusions Treatment of benign stricture of porta hepatic duct by pedicled autograft is physiologic, convenient and effective.