儿童先天性胆管扩张症根治术后再手术相关原因分析

目的:探讨儿童先天性胆管扩张症根治术后再手术的相关原因.方法:收集我院15例先天性胆管扩张症根治术后再手术的病例资料,与同期未发生再手术的病例进行对比.结果:其中急诊手术的再手术率显著高于择期手术者,囊肿外引流术、囊肿十二指肠吻合术及囊肿空肠Rouxen-y吻合术的再手术发生率较高,而囊肿切除肝总管空肠吻合术、肝叶切除肝外囊肿切除肝总管空肠吻合术的发生率较低,各手术方式之间再手术发生率的差异显著(P<0.05).结论:先天性胆管扩张症确诊后应尽早手术,囊肿外引流术和囊肿内引流术的再手术发生率较高,除非急诊手术作为一种辅助措施,一般情况下不要选用,尽量给与彻底切除,囊肿切除术、肝总管Rouxen-y吻合术是本病的首选术式.

Cause Analysis of Children with Congenital Biliary Dilatation after Radical Operation Again

Objective:To study of congenital bile duct dilatation after radical operation and related reasons.Methods:The data of 15 cases of congenital bile duct dilatation after radical operation cases over the same period,and did not occur again operation case comparison.Results:The emergency operation to operation rate was significantly higher than that of elective operation,the cyst drainage,cysts duodenal anastomosis and cyst jejunum anastomosis of Rouxen-y operation occurs at a higher rate,and cyst resection of hepatic duct jejunum anastomosis,hepatectomy extrahepatic cyst resection of hepatic duct jejunum anastomosis occurred at a lower rate,the operation modes re operation of the differences in the incidence of significant(P<0.05).Conclusion:Congenital dilatation of the bile duct diagnosed as soon as possible after operation,the cyst drainage and surgical internal drainage operation of a higher incidence,unless in emergency operation as an adjunctive measures,in general do not choose,try to give complete resection,cyst resection,hepatic duct Rouxen-y anastomosis is the preferred surgical disease.