良性胆管狭窄242例的外科疗效分析

Surgical treatment for benign bile duct strictures in 242 cases

目的 分析影响良性胆管狭窄外科疗效的因素。方法 总结1990-2005年242例良性胆管狭窄的资料，对胆管狭窄的病因、狭窄部位、手术时机、手术方式与疗效的关系进行分析。结果 （1）病因：损伤性胆管狭窄、胆结石继发胆管狭窄、胆总管囊肿所致胆管狭窄外科疗效的优良率分别为94．1％、71．4％、100％；（2）狭窄部位：胆肠吻合口狭窄最多见，在损伤性和结石性胆管狭窄中，其手术治疗优良率分别为100％和88．2％；（3）手术时机：紧急手术＋早期手术及早期手术者效果最佳，优良率100％；（4）手术方式：胆肠吻合、胆管修复、介入治疗的优良率分别为90．9％、92．3％、63．2％。结论 根据不同的病因和狭窄部位的特点，选择恰当的手术时机和手术方式可有效提高良性胆管狭窄的治疗效果。

Objective To analyse factors influencing surgical result in patients with benign bile duct strictures. Methods The clinical data of 242 cases with benign bile duct strictures from 1990 to 2005 were summaried and relationships between etiological factor, stricture classification, timing of operation, operative modality and therapy effect were analyzed. Results 1. Etiological factor：Surgical result of bile duct stricture derived from injury,calculus and choledochal cyst was excellent respectively in 94. 1% ,71.4% and 100%. 2. Stricture site： Cholangio-intestinal anastomotic stricture was most often seen and the surgical result of bile duct stricture derived from injury and calculus was excellent in 100% and 88.2% respectively. 3. Timing of operation：Emergency plus early operation and early operation alone result in 100% excellence. 4. Operation mode： Surgical result of cholangio-intestinal anastomosis, repair, interventional therapy was excellent in 90.9% ,92.3% ,and 63.2% respectively. Conclusion Treatment result of benign bile duct strictures could be significantly improved by choosing appropriate timing and mode of operation on the basis of various cause and site of bile duct strictures.