改良套入式胆肠吻合术在小口径胆肠吻合术中的临床应用研究

The clinical application of modified intussusceptive choledochojejunostomy in small-diameter eholedochojejunostomy

目的通过改进小口径胆肠吻合缝合技术，减少胆瘘、胆管狭窄等术后并发症的发生率。方法自2007年6月至2011年6月对52例小口径胆肠吻合手术采用改良套人式胆肠吻合术。结果本组病例术后3例出现吻合口瘘，经保守治疗后痊愈，全部病例均未出现术后胆管狭窄，无手术死亡，每个吻合口平均操作约12．5min，明显缩短了手术时间。结论改良套人式胆肠吻合术在小口径胆肠吻合术中的应用能有效地避免术后吻合口瘘与狭窄的发生，同时操作简便、省时，在临床上切实可行，安全可靠。

Objective To lower the incidence rate of postoperative complications including biliary fistula and bile duct stricture by improving the technique of cholangiojejunostomy. Methods 52 patients received modified intussusceptive choledochojejunostomy for small-diameter surgery during June 2007 to June 2011. Results Three patients developed postoperative anastomotic fistula but were cured with conservative treatment. No postoperative biliary stricture or procedure-related death occcurred. The surgical duration was obviousely shorter, with an average length of approximately 12.5 rain for each anastomotic stoma. Conclusions Application of modified intussusceptive choledochojejunostomy in small-diameter choledochojejunostomy can effectively avoid the development of postoperative anastomotic leakage and bile duct stricture. It is feasible, safe, and easy to operate in the clinical practice.