胆总管空肠T管搭桥术对晚期胰头癌的减黄治疗效果观察

目的: 探讨晚期胰头癌的姑息性减黄手术方式.方法: 对我院2000年1月至2004年10月间收治的40例晚期胰头癌病人分别行胆总管空肠Roux-Y吻合术和胆总管-空肠T管架桥术后按手术方式分组,对手术时间、术后并发症、肝功能、生活质量评分(根据Karnofsky评分标准)等指标进行观察对比.结果: 胆总管-空肠T管架桥术组比Roux-Y组手术时间短,术后并发症发生率低,血清总胆红素和肝功能恢复快,胃肠功能恢复时间短,生活质量高.结论: 对于高龄、全身情况差、不能耐受长时间手术的患者,胆总管-空肠T管架桥手术不失为一种理想的手术方式.

Observation of therapeutic effectivess on the choledoco-jejunum T tube bridge to treat jaundice in advanced adenocarcinoma of pancreatic head

Objective:To study the palliative operation for treating jaundice in patients with advanced pancreatic head adenocarcinoma.Methods:Forty cases admitted to our hospital from Jan.2000 to Sep.2004 with advanced pancreatic head adenocarcinoma underwent different internal drainage operation respectively were divided according to their operative methods into two groups:Roux-Y choledochojejunostomy and internal drainage through T tube to build bridge between common bile duct and jejunum. Then the difference between the two groups was compared in following aspects:operation time,postoperative complication,function of liver,total serum bilirubin and evaluation of life quality and so on.Results:Compared with Roux-Y choledochojejunostomy,T tube internal drainage between common bile duct and jejunum had a shorter span of operation time,less postoperative complication,better restoration of liver function and total serum bilirubin,rapid recovery of gastrointestinal function and improvement of life quality.Conclusion:T tube internal drainage between common bile duct and jejunum is a more effective way to relieve jaundice for the patients with advanced pancreatic adenocarcinoma,who are aged,bad general condition and seems hardly to tolerate the procedure of operation.