CAJ | 학술논문

目的评价手术修复Mirizzi综合征非周径性胆管缺损的疗效.方法回顾性分析手术修复Mirizzi综合征非周径性胆管缺损32例临床资料,总结采用不同的自身材料修复胆管缺损的治疗效果.结果本组32例手术均成功完成,无手术死亡.其中带蒂胆囊瓣修复胆管缺损25例,带蒂脐静脉瓣修复胆管缺损5例,带蒂大网膜瓣修复胆管缺损2例.术后并发症2例.其中脐静脉瓣修复胆管缺损术后胆漏1例,经引流管引流胆汁,术后7d无胆汁引出,拔除引流管；胆管残余结石1例,术后9个月后经T管窦道胆道镜取出结石.所有病例均在术后9～12个月经T管胆道造影,无结石或胆管狭窄等异常后拔除T管.全部病例均得到随访,随访时间1～5年.全部病例均无胆管狭窄或腹痛、黄疸、发热等胆管炎症状发生.结论采用自身材料如带蒂胆囊瓣、脐静脉瓣及大网膜瓣手术修复Mirizzi综合征胆管缺损的疗效确切,是外科治疗的最佳选择.
목적 평개수술수복Mirizzi종합정비주경성담관결손적료효.방법 회고성분석수술수복Mirizzi종합정비주경성담관결손32례림상자료,총결채용불동적자신재료수복담관결손적치료효과.결과 본조32례수술균성공완성,무수술사망.기중대체담낭판수복담관결손25례,대체제정맥판수복담관결손5례,대체대망막판수복담관결손2례.술후병발증2례.기중제정맥판수복담관결손술후담루1례,경인류관인류담즙,술후7d무담즙인출,발제인류관；담관잔여결석1례,술후9개월후경T관두도담도경취출결석.소유병례균재술후9～12개월경T관담도조영,무결석혹담관협착등이상후발제T관.전부병례균득도수방,수방시간1～5년.전부병례균무담관협착혹복통、황달、발열등담관염증상발생.결론 채용자신재료여대체담낭판、제정맥판급대망막판수술수복Mirizzi종합정담관결손적료효학절,시외과치료적최가선택.
Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.