皮下盲袢式间置空肠胆管空肠吻合术的临床研究

目的 探讨皮下盲袢式间置空肠胆管空肠吻合术治疗胆道手术后残存结石的作用及效果.方法 对通过72例复发胆石症行皮下盲袢间置空肠胆管空肠吻合术的临床资料进行回顾性分析.结果 探查胆总管近远端,若Oddis括约肌可通过8～10号探子,则游离带血管蒂空肠10～15 cm,空肠近端与胆总管端侧吻合,空肠远端做盲袢,置于相应腹壁皮下,胆肠吻合口内留置T管经盲袢做外引流.72例均治愈,无手术并发症及死亡.结论 该术式创伤轻微,术时较短,易于操作,具备胆肠吻合基本技巧的普外科医师均可操作应用.

Clinical study on choledochojejunostomy together with a subcutaneous blind loop of interposed jejunum

Objective:To explore the therapeutic effect of choledochojejunostomy with a subcutaneous blind loop of interposed jejunum for treating postoperative residual biliary stones.Methods :The clinical data of 72 cases of choledochojejunostomy with subcutataneous blind loop of interposed jejunum were retrospectively analysed.Results:After exploration of distal common bole duct, and when a No. 8-10 bougie could pass through the sphincter of Oddi, a 10-15 cm segment of jejunum with its vascular pedicle was mobilized, and an end to-side choledochojejunal anastomosis was performed at the proximal side of the jejunal segment and its distal end was converted to a blind loop and fixed subcutaneously to relevant abdominal wall. A T-tube for external drainage was inserted across the choledochojejunal anastomosis and exited through the blind jejunal loop.Seventy-two patients were cured without any complication or mortality.Conclusions:The procedure is simple and minimally invasive, so that it could be carried out very easily and quickly by general surgeons with basic choledochojejunostomy skill.