Y形口在胆肠吻合术中的应用及疗效探讨

目的探讨Y形口在胆总管后壁分离困难时的胆管空肠Roux-en-Y吻合术中的应用,并与传统方法进行比较,探讨改良胆管空肠Roux-en-Y吻合术的临床价值。方法回顾分析改良胆管空肠Roux-en-Y吻合术36例,并与26例传统端侧式胆肠吻合术进行比较分析,评价两种手术方式的手术时间、术中出血、住院时间、术后恢复情况、远期疗效和并发症等情况。结果无死亡患者,术中出血量减少、手术时间缩短、无胆漏、吻合口狭窄等并发症,临床效果满意。结论Y形口胆肠吻合术应用于胆管后壁分离困难的患者时,操作简易,术中出血量少,可缩短手术时间及住院时间,相对并发症少;在胆总管后壁分离困难时的胆管空肠Roux-en-Y吻合术中有一定临床应用意义。

Study on clinical experience and efficacy of improvedroux-en-Y cholangiojejunostomy with y shaped incision

Objective To investigate the clinical experience of improved Roux-en-Y cholangiojejunostomy with y shaped incision,when biliary tracts are difficult to separate;and compared efficacy with regular Roux-en-Y cholangiojejunostomy.Methods Did a retrospective analysis of 66 cases of Roux-en-Y cholangiojejunostomy when biliary tracts are difficult to separate,including 36 cases used improved methods and 30 cases used regular methods.Operation time,intraoperative bleeding,hospitalization time,recovery condition after operation,long-term effect and postoperative complications were compared.Results The clinical results were satisfactory.There was no patient dead and bile leakage complications.Also,operation time,intraoperative bleeding volume and hospitalization time were reduced.Conclusion Compared with the traditional methods,improved biliary-enteric Roux-en-Y cholangiojejunostomy with y shaped incision has exact curative.This operation is simple and easy,also could reduce blood loss and complications,shorten operative time.It has certain clinical significance especially for patients whose biliary tracts are difficult to separate.