空肠肝管Roux-en-Y吻合加皮下盲袢治疗肝内胆管结石的体会

Experiences about Jejunum Roux-en-Y Anastomosis of Hepatic Duct of the Blind Loop in the Treatment of Hepatolithiasis Subcutaneous

目的:探讨空肠肝管Roux-en-Y吻合加皮下盲袢治疗肝内胆管结石的临床疗效。方法:选取32例肝内胆管结石患者,均接受皮下盲袢型胆肠吻合术,对患者的术中情况、临床疗效及术后随访情况进行观察。结果:32例患者症状均得到缓解,优良率为100%;结石残留和复发8例,复发率25%,其中经胆肠吻合口冲出结石2例,其余6例经皮肤小切口皮下盲袢行胆镜取石;胆管炎6例,发生率19%。结论:皮下盲袢这一永久通道可穿刺胆道造影、冲洗、引流,还可小切口经胆道镜取石,扩张解除肝胆管狭窄,最大程度减少患者再手术痛苦。

Objective： To investigate the clinical effect of jejunum Roux-en-Y anastomosis of hepatic duct subcutaneous blind loop in the treatment of hepatolithiasis. Method： 32 cases of intrahepatic bile duct stone patients,were received subcutaneous blind loop type biliary enteric anastomosis of follow-up, clinical effect and operation situation, after the patients were observed.Result： 32 patients symptoms were alleviated, the excellent and good rate were 100%; 8 cases of residual stone and recurrence, the recurrence rate 25%, where in the bilioenteric anastomotic out of stones in 2 cases, the other 6 cases of skin incision subcutaneous blind loop for bile duct stone; cholangitis in 6 cases, the incidence was 19%. Conclusion： Subcutaneous blind loop of a permanent channel can puncture cholangiography,irrigation,drainage,but also small incision by choledochoscopy for bile duct stricture, expansion release, reduce the patients＇ pain before operation.