胆道闭锁手术空肠胆支造瘘与防返流瓣的比较研究

Study of Hepatic Portoenterostomy with Cutaneous Jejunal Enterostomy and Antireflux Spur Valve Technique in surgical Treatment of Biliary Atresia

目的：为对肝门空肠吻合加空肠胆支造瘘术与加胆支防返流瓣成形术，这两种术式的优缺点进行比较．方法： ４８例胆道闭锁分为两组。 Ａ组 ２４例胆道闭锁行肝门空肠 Ｒｏｕｘ－Ｙ吻合，空肠胆支造瘘术． Ｂ组为另外２４例行肝门空肠Ｒｏｕｘ－Ｙ吻合，空肠胆支防返流瓣成形术。对这两组术后情况进行回顾性分析．结果： Ａ组９例存活，均无黄疸，最长的已 ９年， １例出现肝脾肿大、食道静脉曲张．现已 ８岁． Ｂ组存活 １０例，其中无黄疸存活８例．结论：两组病例术后排胆汁（或排黄绿色大便）时间、胆管炎发生次数等临床表现进行比较．排胆汁时间相似，无显著差异．术后胆管炎发生率也无显著差异．

Objective: To .compare with merits and demerits of two operations to treat binary atresia. Methods: 48 patients with binary atresia were divided into two groups underwent hepatic portoenterostomy with cutaneous jejunal enterostomy (Group A) and Roux-Y with antireflux spur valves (Group B) respectively. Results: There are 9 cases remaining A. All of 9 cases survived without jaundice the oldest one being 9-year old. One of 9 was portal hypertension. The other one who survived with jaundice and portal hypertension is 7 years old now. 10 cases in group B remaining alive. of them, 8 survived without jaundice and 2 with jaundice. Conclusions: The time of bile excretion, number of cholangitis attacks and the clinical manifestations in both groups of patients were compared, but no remarkable statistical difference was found, especially in the incidence of postoperative cholangitis. Two kinds of operation have similar effect in preventing reflux cholangitis, while spur valve wasn't leave a cutaneous enterostomy.