CAJ | 학술논문

目的探讨胆总管探查术后胆总管末端狭窄的预后.方法对1998年1月至2007年1月,64例胆囊切除胆总管探查术后T管造影发现胆总管末端狭窄患者资料进行回顾性分析.其中未做任何处理拔管30例.延长带管时间到6个月,复查T管造影后再拔管14例.7例夹闭T管有症状,其中3例逐渐延长夹管时间J后再拔管；另4例一直未能夹管,第一次术后3个月再次手术.行气囊扩张置管支撑半年后拔管13例.结果能够夹闭T管的47例中,41例(87.23％)在2～6年的随访期内没有出现胆道梗阻症状.6例出现胆道梗阻症状,占12.77％.气囊扩张后支撑半年的13例中,7例出现胆道梗阻症状,占53.85％.结论胆总管探查术后,胆道造影发现胆总管末端狭窄；如果能夹闭T管,最妥当的临床处理是可以不做任何处理拔管,密切随访.
목적 탐토담총관탐사술후담총관말단협착적예후.방법 대1998년1월지2007년1월,64례담낭절제담총관탐사술후T관조영발현담총관말단협착환자자료진행회고성분석.기중미주임하처리발관30례.연장대관시간도6개월,복사T관조영후재발관14례.7례협폐T관유증상,기중3례축점연장협관시간J후재발관；령4례일직미능협관,제일차술후3개월재차수술.행기낭확장치관지탱반년후발관13례.결과 능구협폐T관적47례중,41례(87.23％)재2～6년적수방기내몰유출현담도경조증상.6례출현담도경조증상,점12.77％.기낭확장후지탱반년적13례중,7례출현담도경조증상,점53.85％.결론 담총관탐사술후,담도조영발현담총관말단협착；여과능협폐T관,최타당적림상처리시가이불주임하처리발관,밀절수방.
Objective To review the management of distal common bile duct stenosis found on Ttube cholangiography.Methods This is a retrospective study on 63 patients who were found to have a distal common bile duct stenosis on T-tube cholangiography after cholecystectomy and bile duct exploration.In 30 patients,the T tube was removed.In 14 patients,the T tube was kept draining for 6 month.Seven patients developed biliary obstructive symptoms after the T-tube was spigotted,but in 3 of these patients,the T-tube could finally be removed by prolonging the spigotted time.In the remaining 4 patients,another operation was required 3 month after the first operation.In 13 patients the T tube was taken out after 6 months following balloon dilation.Results In 47 patients in whom the Ttube could be spigotted,41 patients (87.23％) did not develop any biliary obstructive symptoms on follow up for 2 6 years,while 6 patients developed biliary obstructive symptoms (12.77％).In 13 patients who received halloon dilation,7 developed biliary obstructive symptorns (53.85％).Conclusions In patients after common bile duct exploration,if distal common bile duct stenosis was found on T-tube cholangiography,the T-lube could he spigotted and the T-tube could be taken out if no obstructive symptoms developed.