摘要
目的:探讨胆总管十二指肠吻合术治疗老年人胆总管结石的临床效果,评估该术式的可行性。方法回顾分析潍坊市中医院1994年12月~2014年6月采用胆总管十二指肠吻合术治疗516例老年胆总管结石患者的临床及随访资料。结果本组516例手术均顺利完成,手术时间50~90(65±6)min,术后平均住院时间(11±2)d。术后20例发生近期并发症,包括切口感染5例,脂肪液化7例,肺内感染5例,充血性心力衰竭3例。498例随访2~16(6.5±3.5)年,随访率96.5%.发生肠梗阻4例,切口疝2例,返流性胆管炎7例,没有结石复发、盲端综合征及胆管癌等远期并发症发生。结论胆总管十二肠吻合术治疗胆总管结石具有防止结石复发、手术并发症少、返流性胆管炎发生率低及操作简便易行等优点,值得推广应用。
Objective To explore the clinical value of choledochoduodenostomy in the treatment of choledo-cholithiasis in elderly patients and evaluate the feasibility of the operation .Methods A retrospective analysis was made on the clinical and follow-up data of 516 elderly patients who suffered from choledocholithiasis and were treated with cho-ledochoduodenostomy from Dec .1994 to Jun.2014.Results All 516 operations were successfully performed .Operation time was 50~90minutes,mean operation time was (65 ±6)minutes.The mean postoperative hospital stay was (11 ±2) d.After surgery recent complications occurred in 20 patients including incision infection in 5 cases,fat liquefaction 7 ca-ses,pulmonary infection 5 cases and congestive heart failure 3 cases.498 cases were followed up for 2~16 years.The mean duration of follow-up were(6.5~3.5) years,follow-up rate was 96.5%.4 cases of intestinal obstruction ,2 cases of incision hernia and 7 cases of reflux cholangitis were found ,no long-term complications such as recurrence of calculus , blind side syndrome and bile duct carcinoma occurred .Conclusion Choledochoduodenostomy in the treatment of chole-docholithiasis has obvious advantages such as preventing stone recurrence ,less complications ,the low incidence of reflux cholangitis and easy and simply operation .The operation is worth to be popularized and applied .
出处
《潍坊医学院学报》
2015年第4期268-270,共3页
Acta Academiae Medicinae Weifang