CAJ | 학술논문

目的通过术后胆道镜的观察,了解胆肠吻合中的人工乳头瓣膜的防反流效果,探讨胆肠吻合术及人工瓣膜的可行性及其对肝胆管结石复发干预的有效性.方法 51例肝胆管结石病行胆肠Roux-en-Y吻合术的病例.术中均在空肠输出肠袢行人工乳头防反流瓣.术后胆道镜通过T管窦道进入肝胆管,观察肝内外胆道、胆肠吻合口及其反流情况.对于复发的2例通过穿刺建立通道,应用胆道镜进行观察和治疗.结果术后44例发生胆肠反流(44/51.86.3%); 2例术后复发通过胆道镜诊治,1例结石松软,内以食物渣,纤维素为主.另外1例为松散的食物团.结论胆肠Roux-en-Y吻合术、空肠输出肠袢行人工乳头防反流瓣并未有效地解决胆肠反流的弊端,复发的结石与反流有关.因此,应该严格和谨慎使用胆肠吻合术.
목적 통과술후담도경적관찰,료해담장문합중적인공유두판막적방반류효과,탐토담장문합술급인공판막적가행성급기대간담관결석복발간예적유효성.방법 51례간담관결석병행담장Roux-en-Y문합술적병례.술중균재공장수출장번행인공유두방반류판.술후담도경통과T관두도진입간담관,관찰간내외담도、담장문합구급기반류정황.대우복발적2례통과천자건립통도,응용담도경진행관찰화치료.결과 술후44례발생담장반류(44/51.86.3%); 2례술후복발통과담도경진치,1례결석송연,내이식물사,섬유소위주.령외1례위송산적식물단.결론 담장Roux-en-Y문합술、공장수출장번행인공유두방반류판병미유효지해결담장반류적폐단,복발적결석여반류유관.인차,응해엄격화근신사용담장문합술.
Objective To investigate the effect of artificial valve of efferent loop in preventing reflux by the choledochoscopy technique and evaluate its feasibility and efficacy of means of preventing refluxes influencing hepatolithiasis relapse after choledochojejunostomy.Methods A total of 51 cases with hepatolithiasis had been operated on with Roux-Y cholangioiejunostomy and artificial valve of ef-ferent loop to prevent biliointestinal regurgitation.The regurgitation,recurrence,biliary duct and the anastomotic ora were investigated through the T tube sinus by the choledochoscopy after operation.Through sinus built by the percutaneous puncture,we had treated and observed 2 eases with hepatoli-thiasis relapse by the choledochoscopy.Results Of the 44 cases having the biliointestinal regurgitation (44/51.86.3%),2 with hepatolithiasis relapse post-choledochojejunostomy were diagnosed and trea-ted with choledochoscopy.The stones in 1 case were soft and there were many food residue and cellu-lose.Conclusion Roux-en-Y choledochojej unostomy and subjoining the artificial valve of efferent loop is not effective in preventing reflux.Relapsing of the calculus has something to do with biliointestinal regurgitation.Therefore,the choledochojejunostomy should be taken cautiously and strictly.