皮下空肠盲袢胆道造口成形术治疗肝胆管结石及狭窄(附64例报告)

治疗肝胆管结石的手术方法很多，各有所长，但较普遍存在着残石率高、并发症多、再手术率高等棘手的问题。针对上述问题，作者于1988年设计了皮下空肠盲拌胆道造口成形术，并在64例肝胆管结石手术中应用，临床疗效满意，现报告如下。1材料和方法1．1临床资料本组64例，男23例，女41例，年龄21～63岁，平均39岁，27例以往做过胆道手术。术中所见：肝内胆管结石16例，肝内外胆管7例，肝外胆管结石11例。64例中并肝胆管狭窄26例，占本组40．62％，全部患者均有明显肝胆管扩张。手术方式：38例肝胆管结石行空肠盲拌胆道造口术，26例肝胆管结石井…

Therapy of hepatolithiasis by cholangiostomy and cholangioplasty with subcutaneous blind jejunal loop

In 1988,the authors designed cholangiostomy and cholangioplasty with subcutaneous free blind je junal loop and applied it to 64 hepatolithiasis operations,the effects of the operations were satisfactory. The operation proudure is as follows:incise and explore the extrahepatic bile duct,extrat the biliary stones and plastic operation at the biliary stenosis.Take a piece of 10cm free jejunum with mesentery for cholangiostomy or cholangioplasty,anastomose the distal end of jejunum and the extrahepatic duct,close proximal jejunal stump and fix it to the subcutaneous zone in the incision. 14 of the 64 cases were treated with drainage of biliary tract. After cholangionraphy, 12 of them were found with residual stones in extrahepatic bile duct and the stones were extracted through the subcutaneous blindjejunal loop, 11 cases were cured with a cure rate of 91. 66 %. The greatest advantage of the techniques is that they can simplify the treatment of postoperation residual or recurrent stones.