胆肠吻合术后吻合口瘢痕形成的机制及治疗现状

Mechanism and treatment of anastomotic scar after choledochostomy

胆肠吻合术被广泛应用于胆道疾病以及部分胰腺疾病手术治疗后的胆道重建,然而胆肠吻合口在愈合过程中,涉及多种炎性因子及不同的调节通路,最终不可避免会有瘢痕生成。过度的瘢痕反应将造成吻合口瘢痕狭窄,必须予以治疗。目前临床上治疗胆肠吻合口瘢痕性狭窄的主要方法是介入治疗,严重患者则需要再次接受手术治疗。整体而言,对于胆肠吻合口瘢痕的治疗相对滞后,有很多潜在的早期治疗方案值得关注。本文旨在对胆肠吻合术及吻合口瘢痕相关形成机制、治疗方式进行综述。以期更好地预防和治疗瘢痕。

Choledochojejunostomy is used in biliary diseases and part of the pancreas disease after surgical treatment of biliary reconstruction,the process of healing of biliointestinal anastomosis,involves a variety of inflammatory factors and different regulatory pathways,and eventually scarring is inevitable.Excessive scar response will result in anastomotic scar stricture,which will have to be treated..At present,interventional therapy is the main method to treat the scar stricture of biliointestinal anastomosis.On the whole,the treatment of bilioenteric anastomotic scar is relatively lagging behind,and there are many potential early treatment options worthy of attention,in order to better prevent and treat scar.The purpose of this article is to review the mechanism and treatment of choledochojejunostomy and anastomotic scar formation.