保留幽门胆管胃肠双改道治疗乳头旁憩室

The technique of retention pylorus add diplex rout-changing com m e bile duct and stom ach-intestine for curing juxtapapillary duodenal diverticula

目的 探讨治疗乳头旁憩室的一种术式效果。方法 于幽门下３ ｃｍ 断十二指肠，其远端与横断的胆总管行端端或端侧吻合，Ｔｒｉｔｚ韧带下１５ ｃｍ 断空肠，远端空肠与近端十二指肠行端端吻合，距此吻合口下４０ ｃｍ 处行近端空肠与空肠端侧吻合。结果 本组无手术死亡，仅１例出现吻合口水肿，２ 例发生胃排空障碍，经保守治疗后缓解。随访７例，６例效果优，１ 例效果良。结论 保留幽门胆管胃肠双改道术是一种治疗乳头旁憩室有效的术式。

Objective To study a surgery technique for juxtapapillary diverticula. Methods The main pointofthe technique:To shutoffduodenum below pylorus3 cm ,and after transecting com m on bile duct(CBD),to oversew CBDand distalduodenum by end to end;below tritzligam ent 15 cm shutting offjejunum ,and to oversew distaljejunum and nearend duodenum ; below the anastomolic stom a 40 cm ,to oversew the nearend jejunum and jejunum by end to side,to m akd up ofY shape.Results None of8 cases died because ofoperation,only one of them had edem a ofanastom olic stom in postoperative,2 ofthem had evacuation disturbance ofstom ach,the occur rate is 25% .Following-up survey 7 cases,6 ofthem were excellent,one ofthem was fine. Conclusions The treatm entofretention pylorusadd diplex rout-changing com m e bile ductand stom ach-intestine isa good technique. [