肝内肝管空肠吻合治疗恶性肝门部胆管梗阻(附14例报告)

Treatment of Malignant Hilar Obstruction by Tertiary Hepatico－jejunostomy(A Report of 14 Cases)

目的：观察与评价肝内肝管空肠吻合术治疗恶性肝门部胆管梗阻的减黄效果。方法：切除部分肝左外侧叶，解剖出左外下段支肝管或切除右前叶下段部分肝组织，解剖出右前下段支肝管与空肠行Roux－y吻合。结果：有效减黄率，95．0％，肝内胆管回缩率81．4％，早期合并发生例数，1／10例，黄疸再发率，0，平均生存期246天。结论：肝内肝管空肠吻合术对于不能切除的恶性肝门部胆管梗阻是确实可行的治疗方法。

Objective To evaluate the effect of relieving jaundice from malgnant hilar obstruction by tertiary hepatico－jejunostomy． Methods After excising a part of left lateral hepatic lobe dissected out the left lateral infra－segment of the hepatic duct or after excision of partial infra－segment liver tissue of the right anterior lobe and then dissected out the right anterior infra－segment of hepatic duct a Roux－Y tertiary hepatic duct－jejunostomy was made． Results The effective rate of relieving jaundice was 95％． The rebound rate of intraheaptic duct was 81．4％． The case with early complication was 1／10 cases． The relapsing rate of jaundice was 0％ and the median survival time was 246 days． Conclusion The tertiary hepatic duct－jejunostomy is an effective method for relieving jaundice in inoperable malignant hilar obstruction of liver cancer．