中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2013年
4期
255-258
,共4页
黄静%陆才德%吴胜东%卢长江
黃靜%陸纔德%吳勝東%盧長江
황정%륙재덕%오성동%로장강
胆道外科手术%胆结石%支架%手术后并发症
膽道外科手術%膽結石%支架%手術後併髮癥
담도외과수술%담결석%지가%수술후병발증
Biliary tract surgical procedures%Cholelithiasis%Stents%Postoperative complications
目的 探讨不合理胆肠内引流及胆道支架植入治疗肝胆管结石患者的危害及其处理,以期临床能更合理地应用胆肠内引流及胆道支架植入技术.方法 回顾性分析我院2004年6月至2011年12月共55例不合理胆肠内引流及胆道支架植入术后再次手术患者的临床资料,对不合理的原因进行归类分析.结果 55例患者中,肝内胆管结石未处理23例,胆总管十二指肠吻合16例,胆总管空肠侧侧或侧端吻合(不离断胆总管)5例,胆肠吻合技术不恰当2例,输入襻肠段过短3例,不合理的胆道支架植入6例.本组患者均通过再次手术治疗,无围手术期死亡病例,疗效满意.结论 对于肝胆管结石患者,不合理的胆肠内引流技术常常导致治疗失败,加重患者的痛苦,需要再次手术治疗.因此,应该严格把握胆肠内引流及胆道支架植入术的指征,必须注意手术的彻底性及手术操作的规范化,减少胆道再次手术的发生率.
目的 探討不閤理膽腸內引流及膽道支架植入治療肝膽管結石患者的危害及其處理,以期臨床能更閤理地應用膽腸內引流及膽道支架植入技術.方法 迴顧性分析我院2004年6月至2011年12月共55例不閤理膽腸內引流及膽道支架植入術後再次手術患者的臨床資料,對不閤理的原因進行歸類分析.結果 55例患者中,肝內膽管結石未處理23例,膽總管十二指腸吻閤16例,膽總管空腸側側或側耑吻閤(不離斷膽總管)5例,膽腸吻閤技術不恰噹2例,輸入襻腸段過短3例,不閤理的膽道支架植入6例.本組患者均通過再次手術治療,無圍手術期死亡病例,療效滿意.結論 對于肝膽管結石患者,不閤理的膽腸內引流技術常常導緻治療失敗,加重患者的痛苦,需要再次手術治療.因此,應該嚴格把握膽腸內引流及膽道支架植入術的指徵,必鬚註意手術的徹底性及手術操作的規範化,減少膽道再次手術的髮生率.
목적 탐토불합리담장내인류급담도지가식입치료간담관결석환자적위해급기처리,이기림상능경합리지응용담장내인류급담도지가식입기술.방법 회고성분석아원2004년6월지2011년12월공55례불합리담장내인류급담도지가식입술후재차수술환자적림상자료,대불합리적원인진행귀류분석.결과 55례환자중,간내담관결석미처리23례,담총관십이지장문합16례,담총관공장측측혹측단문합(불리단담총관)5례,담장문합기술불흡당2례,수입반장단과단3례,불합리적담도지가식입6례.본조환자균통과재차수술치료,무위수술기사망병례,료효만의.결론 대우간담관결석환자,불합리적담장내인류기술상상도치치료실패,가중환자적통고,수요재차수술치료.인차,응해엄격파악담장내인류급담도지가식입술적지정,필수주의수술적철저성급수술조작적규범화,감소담도재차수술적발생솔.
Objective To discuss the harm and the rectification procedures for patients who have received nonstandard cholangioenterostomy and improper endoscopic retrograde biliary drainage.Method The clinical data of 55 patients who had received nonstandard cholangioenterostomy and improper endoscopic retrograde biliary drainage seen at the Ningbo LiHuiLi Hospital between 2004.6 to2011.12 were retrospectively analyzed.Results There were 23 patients who had stones located intrahepatically which had not been dealt with in the previous operation; 16 patients received choledochoduodenostomy; 5 patients received side-to-side or side-to-end cholangiojejunostomy (with no division of the common bile duct) ; 2 patients developed anastomotic stricture after nonstandard cholangioenterostomy; 3 patients had a short efferent loop of jejunum; and 6 patients had improper endoscopic retrograde biliary drainage.Through reoperative rectification,all patients had satisfactory therapeutic outcomes.Conclusions For hepatolithiasis patients,nonstandard cholangioenterostomy and improper endoscopic retrograde biliary drainage not only cause harm to the patients,but also force patients to have a reoperation.Thus,following strict operative indications,choosing the right operation and improving on the operative skills are the keys to prevent a reoperation.
