胆肠Roux-en-Y吻合术后桥袢结石的临床诊治

目的 总结胆肠Roux-en-Y吻合术后桥袢结石的诊治体会.方法 回顾性分析湖南省人民医院2020年1月至2021年6月4例经腹腔镜再手术治疗桥袢结石患者的临床资料.结果 所有患者均在腹腔镜下完成手术,无中转开腹病例.3例行桥袢切开取石术,1例行胆肠吻合口重建术.手术平均时间为(280.7±15.5)min,术中平均出...

Diagnosis and treatment of intestinal loop stones after Roux-en-Y cholangiojejunostomy

Objective To summarize the experience of diagnosis and treatment of intestinal loop stones after Roux-en-Y cholangiojejunostomy. Methods Clinical data of 4 patients with intestinal loop stone who underwent reoperation by laparoscopic surgery in Hunan Provincial People's Hospital from Jan. 2020 to Jun. 2021 were retrospectively analyzed. Results All cases underwent laparoscopic surgery, there was no conversion to laparotomy. Among 4 cases, 3 underwent stones extraction by incision of intestinal loop, 1 case underwent reconstruction of biliary enterostomy. The mean operation time was (280.7±15.5)min, the mean intraoperative bleeding volume was (112.5±31.4)mL, the mean postoperative hospitalization time was (8.3±0.4)d, and the mean time of postoperative gastrointestinal function recovery was (2.5±1.2)d, and no postoperative complication occurred. Conclusion Combined with clinical symptoms and imaging examinations, which is helpful for the diagnosis of intestinal loop stones after Roux-en-Y cholangiojejunostomy. Laparoscopic intestinal loop incision to remove stones and reconstruction of biliary enterostomy, does not increase the hospitalization time and postoperative complications, which is safe and feasible.