不同肝门胆管成形胆道重建术治疗肝门部胆管狭窄的疗效分析

Curative effect analysis of different hilar bile duct stricture reconstruction on porta hepatic stenosis of bile duct

目的探讨不同手术方式治疗肝门胆管狭窄的临床效果。方法将43例胆管结石合并肝门胆管炎性狭窄患者分为实验组23例与对照组20例。实验组进行带胆囊瓣血管蒂肝门胆管成形术,对照组进行胆管空肠Roux-en-Y吻合术。比较两组胆漏发生率、结石复发率及术后胆管炎发生率。结果两组术后胆漏的发生率差异无统计学意义(P>0.05),实验组结石复发率为4.3%,对照组结石复发率为25.0%,实验组结石复发率低于对照组(P<0.05);实验组术后胆管炎发生率为8.7%,对照组术后胆管炎发生率为30.0%,实验组胆管炎发生率低于对照组(P<0.05)。结论带胆囊瓣血管蒂肝门胆管成形术治肝门部胆管狭窄具有较好疗效。

Objective To explore the clinical effect of different methods operandi on porta hepatic stenosis of bile duct.Methods Forty-three patients with bile duct stones complicating porta hepatic stenosis of bile duct were divided into the experimental group （n=23） and control group （n=20）.The patients in experimental group were taken hepatic hilar bile duct plasty with gallbladder flap pedicled,patients in control group were taken biliary intestinal anastomosis in Roux-en-Y ways,incidence rate of bile leakage,recurrence of stones and post-operaive cholangitis were contrasted between experimental group and control group.Results Incidence rate of bile leakage was identical between experimental group and control group （P 0.05）.Recurrence rate of stones was 4.3% in experimental group and was 25.0% in control group,recurrence rate of stones was lower in experimental group than in control group,rate of post-operaive cholangitis was 8.7% in experimental group and was 30.0% in control group,rate of post-operaive cholangitis was lower in experimental group than that of control group.Conclusion Hepatic hilar bile duct plasty with gallbladder flap pedicled in porta hepatic stenosis of bile duct has a good curative effect.