球囊扩张法治疗损伤性胆管狭窄的前瞻性研究

Prospective study on the treatment of traumatic biliary stricture by balloon dilatation

目的探讨球囊扩张法治疗损伤性胆管狭窄（TBS）修复术后再狭窄的效果。方法将1997年2月至2007年2月成都军区总医院收治的81例TBS患者按随机数字表法分成2组：对照组40例，采用传统胆肠吻合术，术后T管支撑6个月；球囊组41例，方法同对照组，同时在吻合口置入球囊，并逐渐扩张肝门部胆管空肠吻合口及上方胆管。两组疗效比较采用X^2检验。结果对照组7例失败（18％），其中6例改用球囊扩张治疗后5例获得成功。球囊组2个月内吻合口径达到12mm，再维持1个月后将T管和球囊拔出，仅1例失败（2％）。两组比较差异有统计学意义（X^2=5．10，P〈0．05）。结论球囊扩张法能大大提高TBS修复术的疗效。

Objective To investigate the efficacy of balloon dilatation in the treatment of traumatic biliary stricture （TBS）. Methods Eighty-one patients with TBS who had been admitted into General Hospital of Chengdu Command from February 1997 to February 2007 were divided into 2 groups. In the control group, 40 patients underwent choledoeo-jejunostomy with T tube stenting in the anastomotic stoma for 6 months. In the balloon dilatation group, 41 patients received implantation of the balloon catheters along with the two arms of the T tube in the anastomotie stoma. The efficacy of different surgical procedures were analyzed by chi-square test. Results Seven patients in the control group were failed with a failure rate of 18%. Of the 7 patients, 6 were transferred to receive balloon dilatation and 5 were cured. In the balloon dilatation group, only 1 patient was failed and the failure rate was 2%. The diameter of the anastomotic stoma in the balloon dilatation group was dilated gradually to 12 mm in 3 months. The difference upon the success rate of the operation between the 2 groups had statistical significance （X^2 = 5.10, P 〈 0.05）. Conclusions Balloon dilatation is effective in the treatment of TBS.