胆肠吻合术在高位胆管狭窄治疗中应用

Application of bilioenterostomy in the treatment of hilar bile duct stricture

高位胆管狭窄是胆道外科治疗的难点,胆肠吻合是治疗高位胆管狭窄最重要的手段之一。术前应对胆管狭窄的程度与范围、胆管走行、肝功能状况、全身营养状况、有无合并门静脉高压及胆道感染做出综合评估,结合影像学检查,制定合理手术规划。术中运用合理的肝门解剖和整形技术,充分掌握高位肝胆管空肠吻合的细节,力求一次手术成功,确保吻合口长期通畅。

Hilar bile duct stricture is a difficult problem of biliary surgical treatment. Bilioenterostomy is regarded as one of the most important treatment. To develop a reasonable surgical planning, it is necessary that a comprehensive assessment combined with the imaging examination including the extent of the stricture and travel of the biliary duct, liver function, nutritional status, with or without the portal hypertension and biliary infection. In order to perform a precise choledochojejunostomy, the surgeon should master the hepatic portal anatomy and the shaping technique. So that one can pursue the success rate of the operation and keep a long-time unobstructed anastomosis.