胆肠Roux-en-Y吻合术后胆漏的临床防治探讨

Clinical prevention and treatment of bile leakage after the Roux-en-Y biliary-enteric anastomosis

目的探讨胆肠Roux-en-Y吻合术后胆漏的治疗方法和预防措施。方法回顾分析2005年1月~2014年12月我科1 130例施行胆肠Roux-en-Y吻合术后发生胆漏的5例患者临床资料。结果 5例患者均治愈。1例行单纯引流治愈;1例加行B超引导下穿刺引流治愈;3例因有发热、腹痛症状及保守治疗时间过长,行再次手术治愈。结论严格掌握手术适应证、采用恰当的吻合技术及合理的围手术期处理是预防吻合口胆漏的关键。

Objective To explore the therapeutic methods and preventive measures of bile leakage after the Roux-en-Y biliary-enteric anastomosis. Methods Retrospectively analyzed the clinical data of 5 patients with bile leakage of 1 130 cases who had undergone curative surgery of Roux-en-Y biliary-enteric anastomosis in our hospital from Jan 2005 to Dec 2014. Re sults All of 5 cases were cured. 1 case was cured by the simple routine drainage, 1 case was cured by the ultrasound-guided drainage and 3 cases with symptoms of fever, abdominal pain and long-term conservative treatment were finally cured by reop- eration. Conclusion Mastering the operation indications strictly, using appropriate anastomosis and rational perioperative management is the key to prevent the anastomotic bile leakage.