胃手术后并发胆石症62例临床分析

目的探讨胃手术后并发胆石症的原因及防治措施。方法回顾性分析2007-2012年宿迁市人民医院胃手术后并发胆石症62例患者的临床资料。结果 62例患者中行毕Ⅰ式11例,毕Ⅱ式32例,远端胃癌根治术10例,全胃切除食管空肠Roux-en-Y吻合术7例,迷走神经干切断加胃窦切除术2例。上述病例行单纯胆囊切除术31例,胆囊切除胆总管切开取石+T管引流术14例,胆囊切除胆肠吻合术5例,保守治疗12例,其中治愈57例,好转5例。而同期对照施行的全胃切除空肠间置吻合术83例,选择性迷走神经切断加胃窦切除术34例,术后随诊均未发现胆石症。结论通过采取有效的措施可减少和预防胃手术后并发胆石症的发生。

Objective To explore the causes and preventive measures of cholelithiasis after gastric operation. Methods Clinical data of 62 patients of cholelithiasis after gastric operation from 2007 to 2012 were analyzed retrospectively. Results 11 cases of Billroth Ⅰ gastrectomy, 32 cases of BillrothⅡ gastrectomy, 10 cases of radical distal gastrectomy for gastric cancer,7 cases of total gastrectomy with esophogusjejtmum Roux-en-Y anastomosis and 2 cases of truncal vagotomy and antrectomy were performed. The occurrence of cholelithiasis was demonstrated. Simple cholecysteetomy was carried out in 31 cases, choledocholithotomy with T-tube drainage in 14 cases, choledochoenterostomy in 5 cases and conservative therapy in 12 cases.Of them,57 cases were cured and 5 cases improved.83 cases of jejunal interposition reconstruction after total gastrectomy and 34 cases of selective vagotomy and antrectomy during the corresponding period did not encounter cholelithiasis after operation. Conclusion Effective measures should be carried out to decrease and prevent the incidence of cholelithiasis after gastric operation.