带蒂脐静脉瓣修复肝门部胆管狭窄

Surgical repairment of hepatic portal bile duct stenosis with pediculated umbilical vein flap: a report of 38 cases.

目的 探讨带蒂脐静脉瓣修复肝门部胆管狭窄的效果。方法 对１９８７ 年１ 月至１９９６年１２ 月，３８ 例用带蒂脐静脉瓣修复肝门部胆管狭窄患者进行总结。采用带蒂脐静脉瓣移植修复肝门部胆管狭窄２３ 例，肝左外叶切除并脐静脉瓣修复右肝管开口狭窄１１ 例，肝方叶切除或肝中裂劈开并脐静脉瓣修复高位胆管狭窄４ 例。结果 随访率（３４／３８）为８９ ％ ，随访时间超过２．５ 年的有３２ 例，２例因胆总管结石、狭窄复发再次手术。疗效优良率为９３％ 。结论 本术式简单易行，疗效满意，是治疗肝门部胆管狭窄的有效方法。

Objective To evaluate the value of surgical repairment of hepatic portal bile duct stenosis with pediculated umbilical vein flap.Methods Altogether 38 cases with hepatic portal bile duct stenosis repaired by pediculated flap of umbilical vein between Jan. 1987 and Dec. 1996 were reviewed. Of them 23 cases were repaired with pediculated flap of umbilical vein for portal biliary duct stenosis, 11 cases for stenosis at the opening of right hepatic duct, and 4 for hepatolobectomy of lobus quadratus or with cleaving of hepatic medium cleft with high stenosis of biliary duct. Results Altogether 34/38 (89%) cases were followed up. Among them 32 cases were followed for more than 2.5 years. Two cases were found with choledocholithiasis or recurrent stricture which needed reoperation. In 93% cases the treatment was satisfactory. Conclusions This technique is simple, easy and the results are satisfactory, therefore, it is an effective method for hepatic portal bile duct stenosis.