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胆管闭锁行Kasai肝门肠吻合术后的迟发性胆管炎和Roux环梗阻 被引量:1
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作者 Houben C. Phelan S. +1 位作者 Davenport M. 刘凯 《世界核心医学期刊文摘(儿科学分册)》 2006年第11期48-49,共2页
Background/Purpose: Late-onset cholangitis is an uncommon complication after the Kasai operation for biliary atresia.Experience with 3 recent patients illustrates appropriate management.Methods: Retrospective review o... Background/Purpose: Late-onset cholangitis is an uncommon complication after the Kasai operation for biliary atresia.Experience with 3 recent patients illustrates appropriate management.Methods: Retrospective review of patients with late unexplained deterioration in liver function attributed to cholangitis.All underwent quantitative radioisotope hepatobiliary scans to identify the Roux loop obstruction and confirm post operative resolution. The role of percutaneous transhepatic cholangiography and computed tomography scanning was reviewed.Results: Three patients aged 8, 13, and 17 years were identified. All 3 had had a successful Kasai portoenterostomy for type 3 biliary atresia and presented after several virtually trouble-free years with late-onset cholangitis. The radioisotope scans in all 3 patients showed poor tracer uptake by the liver and pooling of the radioisotope at the porta hepatis. Laparotomy confirmed a proximal Roux loop obstruction at the level of the mesocolic window in all. This required mobilization and adhesiolysis and, in 1, correction of an actual stenosis with in the wall of the intestine at this level. All patients had normalization of their liver function postoperatively. All are now well and anicteric at a follow-up of 6 to 12 months. Conclusions:Long-term survivors of the Kasai portoenterostomy for biliaryatresia with immediate deterioration in liver function warrant investigation for possible Roux loop obstruction. Resolution of the obstruction allows preservation of their native liver. 展开更多
关键词 肝门肠吻合术 Kasai ROUX 胆管闭锁 救治经验 粘连松解术 胆管造影术 小肠壁 肝胆管 扫描
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