CAJ | 학술논문

目的探讨肝胆管结石合并支气管胆瘘的诊治方法.方法回顾性分析10年来35例患者的临床资料.结果全组均行手术治疗,修补膈肌瘘口.其中行肝叶切除22例,胆管梗阻狭窄切开整形13例.胆总管T管支撑引流19例,肝断面胆管空肠内引流3例,肝胆管盆式Roux-en-Y内引流术13例.术后支气管胆瘘均无复发,肝内胆管结石残留4例.结论患者咯出极苦的黄色脓痰是较为典型的临床特征.解除胆管梗阻,建立通畅引流是手术治疗的关键.
목적 탐토간담관결석합병지기관담루적진치방법.방법 회고성분석10년래35례환자적림상자료.결과 전조균행수술치료,수보격기루구.기중행간협절제22례,담관경조협착절개정형13례.담총관T관지탱인류19례,간단면담관공장내인류3례,간담관분식Roux-en-Y내인류술13례.술후지기관담루균무복발,간내담관결석잔류4례.결론 환자각출겁고적황색농담시교위전형적림상특정.해제담관경조,건립통창인류시수술치료적관건.
Objective To investigate the diagnosis and treatment of hepatolithiasis complicated by bronchobiliary fistula.Method The data of 35 patients with hepatolithiasis and bronchobiliary fistula treated in our department in the last 10 years were retrospectively studied.Results The operations were:-repair of fistula in the diaphragm (n=35),hepatic segmentectomy (n=22) biliary stricturoplasty (n=13),T-tube drainage of common bile duct (n=19),hepaticojejunostomy (n=3) and bilateral hepatojejunostomy with a Roux-en-Y loop of jejunum (n=13).Residual stones were left in 4 patients.There was no recurrence of the bronchobiliary fistula on follow-up.Conclusions Expectoration of bitter and purulent yellow sputum was an important clinical feature of bronchobiliary fistula.The key steps in a successful operation were reliefing the obstructed bile duct and re-establishment of adequate biliary drainage.