胆道良性病变内引流术式与胆管癌变

目的探讨胆肠引流术后发生的胆管癌的原因。方法回顾分析我院1982年～2000年因胆道良性疾病作胆肠引流术后75例病人的病历和随访记录，按照胆肠吻合术将病人分为胆管空肠．Roux—y吻合术48例。胆管间置空肠吻合术4例，胆总管十二指肠吻合术16例，经十二指肠乳头切开术7例，随访期最长10年。结果胆管空肠Roux—y吻合术后发生吻合口癌2例，胆总管十二指肠吻合术后发生原发性胆管癌1例。发生癌变的病人中为肝内胆管结石及术后反复发生胆管炎者。结论长期胆肠引流和胆管恶性肿瘤存在相关性，可能与术后胆道结石、排石、反复胆管炎有关。

MALIGNANT CHANGE OF BILE DUCT OCCURIN PATIENT WITH INTERNAL DRAINAGE

Objective To explore the reason of occurring cholangiocarainoma caused by biliary-entric drainage.Methods From Jan.1982 to Dec 2000,the clinical data form 75 patients with benign diseases who had undergone biliary-entric surgical drainge were retrospectively analysed.According to the procedutes of biliary-entric drainge,all patients were divided into four groups:Roux-en-Y cholangiojejunostomy(48 cases),interposed jejunal choledochochoduoduenostomy(4 cases),choledochoduodenostomy(16 cases),interposed jejunal choledochochoduoduenostomy(4 cases),choledochoduodenostomy(16 cases) and transduodenal sphincteroplasty(7 cases).The longest time of follow-up was ten years.Result Two of these patients with the calculus of intrahepatic duct and recurrent cholangitis were suffered from anastomotic carcinoma after Roux-en-y cholangiojejunostomy,one occurred primary chlangiocarcinoma aftert choledochoduodenostomy.Conclusion The relationship between Long-term biliary-enteric drainage and biliary tract malignancies might exist and relate to biliary Calculus,discharging calculus and recurrent cholangitis.