超高位胆肠吻合治疗泡型黄疸19例报告

Report of 19 cases of obstructive jaundice of alveolar hydatid disease treated by hepatico-cholangiojejunostomy.

目的 总结 19例肝泡状球蚴病致梗阻性黄疸 ,行超高位胆肠吻合术的治疗经验。方法 肝泡状球蚴病根治性切除 12例 (右半肝 6例 ,左半肝 4例 ,右三叶 2例 )。空肠与右肝管Roux -Y吻合 4例。空肠与左肝管Roux -Y吻合 8例。中肝叶姑息性切除 7例 ,行空肠间置胆肠吻合。结果 18例泡型黄疸病人痊愈出院 ,1例术后发生胆肠瘘 ,死于肝肾综合征。 16例坚持口服吡喹酮和甲苯咪唑。结论 泡型黄疸经泡肝根治性或姑息性切除 ,超高位胆肠吻合可改善肝功能 。

Objective To summarize the experience of treating 19 cases of alveolar hydatid disease with obstructive jaundice by hepatic- cholangiojejunostomy in our hospital. Methods Radical hepatectomy performed in 12 cases (right hemihepatectomy in 6 cases,left hemihepatectomy in 4 cases,right three lobectomy of liver in 2 cases).Hepatojejunostomy was done by jejunum and right hepatic bile duct in 4 cases,hepatojejunostomy by jejunum and left hepatic bile duct in 8 cases.Palliative excision of middle lobe of liver in 7 cases.Results Eighteen cases were cured,in 1 case,anastomotic leakage occurred after operation,and died due to hepatic and renal failure after operation.Sixteen cases insisted taking Mebedazal or Abendazal.Conclusion After radical operation or palliative excision of alveoalr hydatid disease with jaundice,hepaticocholanje junostomy in super-high position can improve liver function,and prolong the suvival time.