胆肠吻合口良性狭窄的切割球囊治疗

Cutting balloon in the treatment of benign anastomotic stricture of hepatoenterostomy

目的观察切割球囊治疗胆肠吻合口良性狭窄的效果，评价其临床价值。方法回顾性分析我院应用CB治疗胆肠吻合口良性狭窄的12例患者资料。所有患者均因梗阻性黄疸或反复胆道感染行MRI或经皮经肝胆道造影（percutaneoustranshepaticcholangiography，PTC）明确胆肠吻合口狭窄，行切割球囊吻合口成形术；术后胆道造影提示胆道通畅后拔除引流管，并随访1年。结果12例患者均手术成功，黄疸、胆道感染均好转。3例患者出现短期并发症。随访1年内，1例患者肿瘤复发，2例患者出现胆管结石伴胆道感染，经对症处理后好转。结论切割球囊治疗胆肠吻合口狭窄安全、有效、微创。

Objective To investigate the early outcome of cutting balloon （PCB） in the management of hepatoenterostomy stricture. Methods The clinical data of 12 cases of supposed benign anastomotic strictures after hepatoenterostomy were retrospectively studied. Hepatic duct jejunal anastomotic stricture was confirmed by MRI or PTC, and patients underwent anastomosis plastic repair by CB. Biliary drains tube were removed when free flow of the contrast material through the anastomosis was observed by cholangiography at least 2 weeks postoperative. The follow-up period was 1 year. Results Cutting balloon procedures were successful in all the 12 cases. The symptoms of jaundice and infection were abated. 3 cases suffered from postoperative transient complications. On follow up, 1 patient died of tumor recurrence, 2 patients reported biliary calculi associated with actue cholangitis which were relieved after corresponding treatment. Conclusions Cutting balloon repair of the biliary-enteric anastomotic strictures is a safe, reliable and minitraumatic procedure.