肝外胆管炎性闭塞的外科治疗

SURGICAL TREATMENT OF PHLOGISTIC OBSTRUCTION OF BILE DUCT OUTSIDE LIVER

目的 探讨肝外胆管炎性闭塞预防及治疗的有效方法。 方法 对 5例肝外胆管炎性闭塞患者的治疗过程进行回顾性分析。结果 一期行肝管成形 ,胆肠吻合 3例 ;分期手术 2例 ,先行胆管空肠架桥内引流术 ,二期行胆肠吻合术。 5例均随访 ,随访时间 1-7年 ,无症状复发。结论 严格把握肝外胆管探查指征 ,选用合适的 T管 ,精细手术操作 ,避免损伤胆管粘膜及保护胆管营养动脉是预防本病的关键。根据个体化原则采用合理手术方式解除胆道梗阻、通畅引流是治疗本病的有效方法。

Objective To explore the effective methods of prevention and treatment of phlogistic obstruction of bile duct outside liver.Methods 5 cases with phlogistic obstruction of bile duct outside liver were evaluated in their surgical treatment.Results Plastic operation and hepaticojejunostomy was performed for 3 cases.2 cases operated by stages.First,we set a bridge between the bile duct and the jejunum.Hepaticojejunostomy was performed after a period of time.5 cases have been followed up for 1 to 7 years.No recurrence of symptoms.Conclusion Strictly hold the principle of exploring bile duct outside liver,select appropriate T tube,refinedly operate,avoid injurying the mucous membrane and protect the nutrient artery of bile duct are the keys to prevent the disease.Choice properly operative method by different patients is the effective means to cure the disease.