间置胆囊肝管空肠吻合治疗低位恶性阻塞性黄疸的探讨

Application of hepaticojejunostomy by interposition gallbladder in the palliative treatment of lower malignant biliary obstruction

目的 探讨间置胆囊肝管空肠吻合姑息治疗低位恶性阻塞性黄疸的价值。方法 对2 4例低位恶性阻塞性黄疸采用间置胆囊肝管空肠吻合姑息治疗。结果 2 4例中术后未发生吻合口瘘 ,无胆道逆行感染 ,无手术死亡。血清胆红素下降 14例 (5 8.3 % ) ,术后 15d血清胆红素≤ 171μmol/L ,10例 (4 1.7% )术后 3 0d血清胆红素≤ 171μmol/L ;术后黄疸消退时间 18～ 3 5d ;术后 6个月、12个月、18个月生存率分别为 91.7%、62 .5 %、12 .5 %。结论 间置胆囊肝管空肠吻合是姑息治疗低位恶性阻塞性黄疸的有效措施。

ObjectiveTo explore the value of hepaticojejunostomy by interposition gallbladder in the palliative treatment of lower malignant biliary obstruction.MethodsTwenty-four cases of lower malignant biliary obstruction subject to hepaticojejunostomy by interposition were retrospectively analyzed.ResultsAnastomotic fistulas and retrograde infections did not occur in all 24 cases.Postoperative mortality rate was zero.Serum bilirumin reduction was observed in 14 cases(≤171 μmol/L at day 15) and in 10 cases(≤171 μmol/L at day 30)postoperatively respectively.The withdrawal time of jaundice were 18～35 days.The 6-,12-,18-month survival rate was 91.7%,62.5% and 12.5% respectively.ConclusionThe hepaticojejunostomy by interposition gallbladder in the palliative treatment of lower malignant biliary obstruction is an effective method.