巨大十二指肠憩室切除的手术技巧

目的：探讨巨大十二指肠憩室外科治疗方法。方法：对笔者工作单位及德国海德堡大学外科医院经外科手术治疗的6例巨大十二指肠憩室患者的临床资料进行回顾性分析。 结果：全组6例巨大十二指肠憩室,其中4例采取十二指肠憩室切除+经胃十二指肠造瘘术治疗,另2例采用憩室旷置术,即Billroth-II式胃大部切除 + 胃空肠 Roux-en-Y吻合术。术后均未发生胰瘘、胆瘘、急性胰腺炎及十二指肠瘘等并发症,顺利出院。术后随访3个月至1年半,无1例再出现右上腹部胀痛、不适等症状。结论：巨大十二指肠憩室采取十二指肠憩室切除并经胃十二指肠造瘘术,具有手术效果良好,并发症少等优点。

Surgical treatment of huge duodenal diverticulum

Objective:To explore the methods of surgical treatment of huge duodenal diverticulum.Methods:The clinical data of six cases of huge duodenal diverticulum treated in our hospital and the Surgical Hospital, Heidelberg University during the period of Sep.2008 to Oct.2010 were retrospectively analysed. Results:Of them, four cases underwent duodenal diverticulectomy and transgastric duodenostomy, other two cases were operated by Billroth-II gastrectomy and cholangio-enterostomy. After operation, no complications, such as pancreatic fistula, biliary fistula, duodenal fistula or acute pancreatitis,occured. The patients were folloed-up three months to one and a half years after the operation, and none of the patients experienced any discomfort in the right upper abdomen or any other complications.Conclusions:It is reasonable to adopt duodenal diverticulectomy and transgastric duodenostomy for huge duodenal diverticula. This operation is safe and the complications are few.