经胆囊床右肝管置管胆囊空肠吻合术治疗肝门部癌

TREATMENT OF HILAR CARCINOMA WITH TRANSCHOLECYSTIC BED BRIGHT HEPATIC DUCT CATHETERING DRAINAGE AND CHOLECYS TO JEJUNOSTOMY: REPORT OF 18 CASES

自1983年～1995年,我院对18例肝门部占位梗阻性黄疸,采用经胆囊床右肝管置管胆囊空肠Roux-y吻合内外引流术,术前诊断依靠B超、CT、PTC检查。18例中原发性高性胆管癌8例,胆总管癌侵入肝门4例,转移癌5例,原因不明1例。术后效果满意,生存年限:2年2例,1年12例,6个月2例,4个月1例,另1例术后1年复查一切正常至今。认为本法作为一种胆汁内外引流相结合的手术方法,克服了单纯外引流的胆汁回输困难处境,又克服了单纯内引流的一些手术难度和并发症,具有两种引流的优越性。

From 1983 to 1995. 18patients with obstructive jaundice secondary to hilar mass were performed with transc-holecystic bed right hepatic duct cathetering drainage and Rouxen-y cholecystojejunostomy to relieve jaundice. The preopera-tive diagnosis was made by B-ultrasonograph CT and PTC. Causes of obstruction were of primary high bile duct carcinoma in 8. of common bile duct carcinoma in 4. of metastatic carcinoma in 5, and of unknown cause in 1. The results were satisfied after the operation. The survival time was 2 years in 2 patients, 12 months in 12, 4 months in one, and another case survived till now, but clinical findings were nomal after one year of the operation. It is belived that this operation of combining external drainage with internal drainage had no bile retransfusion difficulty after single external drainage and no any operative difficulty and complication of single internal drainage, and had advantages of both internal and external drainages.