桥袢式胆肠吻合术在肝门胆管癌外科治疗中的应用

CLINICAL APPLICATION OF BRIDGE-SHAPED HEPATICOCHOLANGIOJEJUNOSTOMY IN THE SURGICAL TREATMENT OF HILAR CHOLANGIOCARCINOMA

目的 探讨肝门胆管癌根治切除肝胆管空肠桥袢式吻合术的临床应用价值。方法 对 2 2例肝门胆管癌病人采用肝楔形切除肝胆管空肠桥袢式吻合术 ,检测术前及术后肝功能指标 ,与对照组 18例肝门胆管癌切除加左或右半肝切除术病人进行比较分析。结果 2 2例病人术后切口感染 2例 ,胆瘘 1例 ,经充分引流于术后第 14天恢复正常 ,无严重并发症发生。对照组术后第 3、7、2 1天血清转氨酶明显升高 ,与研究组比较有显著性差异 (P <0 .0 1)。结论 该手术方式安全可靠 ,对肝功能影响小 ,并发症少 ,是肝门胆管癌根治较为理想的手术方法。

Objective To explore the clinical application of bridge-shaped hepaticocholangiojejunostomy in radical operation of hilar cholangiocarcinoma (HCC).Methods 22 cases of HCC underwent bridge-shaped hepaticocholangiojejunostomy after hepatic wedge resections.The preoperative and postoperative liver functions were detected respectively.The results were contrasted with those of the control group of 18 cases of HCC treated with left or right hemihepatectomy.Results In the experimental group,infection of incision wound occurred in 2,bile fistula in 1 and no severe complications in any case.All patients recovered 14 days later.Serum transaminase in the control group increased significantly in the 3rd,7th and 21st days after operation.There existed significant difference between the two groups (P<0.01).Conclusion This kind of operation is safe and effective in treating hilar cholangiocarcinoma.