不同缝合方法在肝移植胆道重建中的应用比较

The use of different biliary suture mode in liver transplantation

目的比较不同的缝合方法在肝移植胆道重建中的应用。方法对上海交通大学医学院附属瑞金医院2002年6月至2005年9月完成的158例肝移植所采用的不同胆道缝合方法及术后胆道并发症进行回顾性分析。结果158例中26例采用间断缝合法,3例发生胆道并发症,其中2例为吻合口狭窄;47例采用连续缝合法,5例发生胆道并发症,其中3例为吻合口狭窄;85例采用改良连续缝合法,6例发生胆道并发症,但无吻合口狭窄。结果显示吻合口狭窄的发生率在3组间的差异有显著性(P<0.05),改良连续缝合法吻合口狭窄的发生率明显低于其他两组。结论改良连续缝合法是一种较理想的胆管缝合方法,可有效降低术后吻合口狭窄的发生率。

Objective To study the use of different biliary suture modes in liver transplantation. Methods The different biliary suture modes and biliary complications were analyzed retrospectively in 158 cases of liver transplantation performed between June 2002 and September 2005 in Rui Jin Hospital affiliated to Medical college of Shanghai JiaoTong University. Results Among 158 cases,interrupted sutures were performed in 26 cases. Biliary complications were identified in 3 cases. Among them,2 cases were anastomotic biliary strictures. Continuous sutures were performed in 47cases. Biliary complications were identified in 5 cases. Among them,3 cases were anastomotic biliary strictures. Improved continuous sutures were performed in 85 cases and biliary complications were identified in 6 cases with no anastomotic biliary stricture identified. The results showed that the difference in the incidence of anastomotic biliary strictures among the three groups was significant（ P 〈0. 05）,and the incidence of anastomotic biliary strictures in the improved continous group was significantly lower than that in the other two groups. Conclusion Improved continous suture is a kind of ideal suture mode which can reduce the incidence of anastomotic biliary strictures.