胆肠吻合术后良性吻合口狭窄的影像学诊断与介入治疗

Imaging diagnosis and interventional therapy of benign anastomotic stricture after biliary enteric anastomosis

目的评价经皮胆管穿刺引流术(PTCD)+球囊扩张术治疗胆肠吻合术后良性吻合口狭窄的疗效。方法回顾性分析采用PTCD+球囊扩张术治疗胆肠吻合术后吻合口良性狭窄的患者13例,评估胆管通畅情况、黄疸指数、肝功能及引流管放置时间。结果对所有患者均成功完成PTCD+球囊扩张术,对其中2例植入金属支架;术后未发生再狭窄,吻合口近期、远期均通畅(13/13,100%);术后黄疸指数、肝功能均明显改善;引流管放置时间为7～98天,平均(57.3±29.9)天。胆管出血3例,无严重并发症发生。结论 PTCD+球囊扩张术可有效治疗胆肠吻合术后吻合口良性狭窄;应根据具体情况选择不同治疗方式。

Objective To evaluate the effect of balloon dilatation for treatment of benign anastomotic stricture after biliary enteric anastomosis with percutaneous transhepatie cholangio drainage （PTCD）. Methods Totally 13 patients with benign anastomotie stricture after biliary enteric anastomosis who underwent PTCD＋balloon dilatation were analyzed retrospec- tively. The patency of bile duct, jaundice index, liver function and drain time were accessed and recorded. Results PTCD-bballoon dilatation was completed successfully in all cases, and metal stents were implanted in 2 cases, with recent and long-term efficiency of 100%（13/13）. None of the patients had re-stenosis. Postoperative jaundice index and liver function were both improved significantly, and draining time was 7--98 （57.3 ± 29.9）days. Bile duct hemorrhage occurred in 3 cases. No serious complications occurred. Conclusion PTCD＋balloon dilation has good curative effect on benign anastomotic stricture. Different operative method should be used according to anastomosis situation.