Title

膽總管囊腫切除後一種防返流的膽腸吻合術式

Translated Titles

A Method to Prevent Biliary Reflux in Hepaticojejunostomy after Excision of Choledochal Cyst

Authors

張中廣(Zhong-Guang Zhang);曲修水(Xiu-Shui Qu);于國慶(Guo-Qing Yu);田亞麗;徐兆雲

Key Words

膽總管囊腫 ; 外科學 ; 膽汁返流 ; Choledochal cyst ; Operation ; Biliary reflux

PublicationName

中國臨床醫學

Volume or Term/Year and Month of Publication

12卷4期(2005 / 08 / 25)

Page #

609 - 610

Content Language

簡體中文

Chinese Abstract

目的:探討先天性膽總管囊腫切除後有效預防膽腸返流的膽道重建手術方法。方法:膽總管囊腫切除之後,行Roux-en-Y膽腸吻合,膽道支與近端空腸支吻合前製作雙重全層U形瓣,寬度與長度為腸管周徑的1/2,瓣膜基底部在上,兩瓣漿膜層相對邊緣間斷縫合,然後將近端空腸與遠端空腸端側吻合。將膽道支空腸於U形瓣基底部上方橫行漿肌層縫合使腸管縮窄1/3,縮窄長度為5cm。再將遠近空腸漿肌層並行縫合5cm以上使之形成Y形。結果:臨床應用於11例病人,術後隨訪0.5~6年,均未出現膽系感染表現,鋇餐檢查各種體位並加壓時均無返流。結論:膽總管囊腫切除後行Roux-en-Y膽道重建時加做膽道支空腸縮窄及雙重U形瓣的防返流術效果可靠,簡單易行。

English Abstract

Objective: To explore a more effective method to deduce or avoid billiary reflux after excision of congenital choledochal cyst (CCC). Methods: After hepaticojejunostomy with Roux-en-Y, two pieces of U-like valve at the distal anastomotic stoma of jejunum were made and suited together. Then the proximal jejunum above the anastomotic stoma of jejunum was sutured longitally for about 5 cm so as to narrow the proximal jejunum to approximately 2/3 of its oringinal width. Then the two branches of jejunum were sutured together longitally above the anastomotic stoma for about 5 cm. Results: Eleven cases of CCC were treated with this method. No one died or had complications. There was no refluxed cholangitis during the follow-up of 0.5 to 6 years. Conclusion: The procedure of narrowing the proximal jejunum and adding dual U-like valves to prevent biliary reflux proved to be effective in preventing biliary reflux in hepaticojejunostomy after excision of choledochal cyst in the treatment of congenital choledochal cyst.

Topic Category 醫藥衛生 > 醫藥衛生綜合