CAJ | 학술논문

目的：探讨空肠壁浆肌层门静脉壁缝合技术在肝门部胆管癌根治性区域切除术后胆道重建的应用价值。方法回顾性分析2009年1月～2013年12月潍坊市人民医院肝胆外科施行的肝门部胆管癌根治性区域切除手术病人45例。根据入院时间及胆道重建方式分为传统胆肠吻合组（ A组）和空肠浆肌层门静脉壁缝合组（ B组）。结果采用传统方式吻合者25例，空肠门静脉缝合技术20例，术后暂时性胆漏发生率分别为36．0％（9/25）和5．0％（1/20）。两组比较，差异有统计学意义（ P＜0．05）；吻合口不同程度狭窄发生率分别为28．0％（7/25）和0（0/20），差异有统计学意义（P＜0．05）。结论采用空肠门静脉缝合技术行肝门胆管癌切除术后的胆道重建，不仅符合手术要求，而且明显降低了术后胆漏及胆肠吻合口狭窄的发生率。
목적：탐토공장벽장기층문정맥벽봉합기술재간문부담관암근치성구역절제술후담도중건적응용개치。방법회고성분석2009년1월～2013년12월유방시인민의원간담외과시행적간문부담관암근치성구역절제수술병인45례。근거입원시간급담도중건방식분위전통담장문합조（ A조）화공장장기층문정맥벽봉합조（ B조）。결과채용전통방식문합자25례，공장문정맥봉합기술20례，술후잠시성담루발생솔분별위36．0％（9/25）화5．0％（1/20）。량조비교，차이유통계학의의（ P＜0．05）；문합구불동정도협착발생솔분별위28．0％（7/25）화0（0/20），차이유통계학의의（P＜0．05）。결론채용공장문정맥봉합기술행간문담관암절제술후적담도중건，불부부합수술요구，이차명현강저료술후담루급담장문합구협착적발생솔。
Objective To explore the value of surgical technique jejunal portal vein suture technique in the treatment for biliary reconstruction in radical regional resection of hilar cholangiocarcinoma .Methods The clinical data of 45 patients with hilar cholangiocarcino-ma surgically treated in our department between Jan .2009 and Dec.2013 were retrospectively analyzed .The patients were divided into 2 groups according to their admission date and mathods of biliary reconstruction ,that were group A ( traditional method ) and group B ( jejunal portal vein suture technique).Results The rate of temporary bile leakage after operation in group A was 36.0%(9/25)and 5.0%(1/20)in group B,and the difference was statistical (P<0.05);the rate of anastomotic stcnosis was 28.0%(7/25) and 0(0/20) respectively with sta-tistical difference between the two groups (P<0.05).Conclusion The surgieal technique of jejunal portal vein suture technique in the treat -ment for hilar cholangiocareinoma is not only in conformity with the requirements of the radical operation ,and can obviously decrease the inci-dence of temporary bile leakage and anastomotic stenosis after operation .