32例Oddi括约肌成形术及其严重并发症分析

An analysis of the plastic repair of Oddi sphincter and serious post-operative complications: A report of 32 cases

目的 探讨Oddi括约肌成形术临床疗效及其严重并发症的防治。方法 观察 32例十二指肠乳头良性狭窄行Oddi括约肌成形术患者术后并发症、临床症状改善情况。结果 2 7例术后无任何并发症发生 ,除 1例长期慢性胰腺炎症状外 ,其余临床症状消失 ,有效率 81 .3 %。 5例 (1 5 % )并发症中 ,严重者 4例 ;急性胰腺炎 1例 ,十二指肠瘘 2例 ,十二指肠梗阻 1例 ,死亡 2例。另外 1例并发轻微上消化道出血 ,经保守治疗痊愈。结论 严格掌握Oddi括约肌成形术的手术适应证 ,其疗效良好 ;术中精细操作可以预防严重并发症发生 ;

Objective To study the clinical therapeutic effects of the plastic repair of Oddi sphincter and the prevention and treatment of serious post operative complications. Methods Thirty two cases of choledochoodditis received the plastic repair of Oddi sphincter. The postoperative complications and the improvement of clinical symptoms and signs were observed. Except 2 dead cases, the remaining patients were followed up for one to 5 years. Results No complications occurred in 27 cases postoperatively. Thereinto, 26 cases ( 81.3% ) were cured and 1 complicated with chronic pancreatitis with the effective rate being 81.3% . Of the 32 cases, 5 had post operative complications, including 4 cases of severe complications: 1 case of acute pancreatitis, 2 cases of duodenal fistula, 1 case of duodenal obstruction, 2 cases died; the remaining one was complicated with mild upper gastrointestinal bleeding and was successfully treated medically. Conclusions To improve the therapeutic effects and reduce the mortality, it is essential to grasp the surgical indications, perform the operation carefully, and early diagnose and manage post operative complications.