Ⅲ、Ⅳ型肝门胆管癌切除术空肠前唇与肝面吻合应用价值研究

Effect of the biliary drainage reconstruction by jejunal foreside to hepatic parenchyma on the Ⅲ Ⅳtype hilar cholangiocarcinoma

目的探讨空肠前唇与肝面吻合在Ⅲ、Ⅳ型肝门胆管癌切除术中应用的安全性和实用性。方法2004年6月至2009年6月间,延边大学附属医院肝胆胰外科对23例获得根治性Ⅲ、Ⅳ型肝门胆管癌切除的病人行术中空肠后唇与肝内胆管后壁吻合后,距吻合口附近空肠内置引流管,空肠戳孔引出。空肠前唇与肝脏面吻合,先在肝面结扎之后用其一根线重新穿引小圆针,于空肠前唇黏膜层进针浆肌层出针给予结扎。结果1例发生胆肠吻合口漏,无一例术后出现吻合口出血和胆肠吻合口狭窄。完成吻合平均时间20min。结论空肠前唇与肝面吻合的方法简易、安全、实用。

Objective To study the technique for anastomosis of jejunal forepart with hepatic parenchyma on the Ⅲ, Ⅳ type hilar cholangiocarcinoma. Methods Twenty-three patients with advanced Ⅲ, Ⅳtype hilar cholangiocellular carcinoma underwent radical resection with jejunum rearside to bile duet rearside between June 2004 and June 2009 at the Department of Hepatobiliary of Yanbian University Hospital. In the cavity of jejunum near anastomosis drainage tube was laid and fetched out. Then hepatic parenehyma to jejunal foreside was sewed up. Results Only one patient occurred anastomotie leakage. None of the patients developed anastomotie blooding and stenosis. The duration for accomplishing the anastomosis was 20 minutes averagely. Conclusion The techniqe of the biliary drainage reconstruction by jejunal foreside to hepatic parenchyma on the hilar eholangiocareinoma can be safe and used routinely.