复杂高位胆管狭窄的手术治疗

目的:研究探讨各种原因引起的高位胆管狭窄的手术方式、疗效和术中B超及造影的应用价值。方法:应用术中B超和造影等特殊方法,确定病变部位并采取各自不同的手术方式治疗复杂高位胆管狭窄。结果:采用各种不同手术方式治疗高位胆管狭窄32例,其中良性狭窄25例,除1例因肝功能衰竭死亡外其余均痊愈。7例高位胆管癌患者只1例生存4年以上,其余6例均于术后8个月至2年内因肿瘤复发死亡。结论:应用术中B超和造影可准确定位狭窄或肿瘤的部位、大小、范围以及与门静脉、肝动脉的关系,即可控制术中大出血,减少医源性损伤,并可大大提高切除率,取得良好治疗效果。

Surgical theraphy of high positional biliary tract stenosis

Objective To debite the methods and of surgical therapy and valuate cholangiography and intraoperative B - mode ultrasonography of high biliary tract stenosis which originate in different disease. Methods Using the methods of cholangiography and intraoperative B - mode ultrasonography, locate the disease. Using different operative methods, tract complex high positional biliary tract stenosis. Remits 32 patients with high positional biliary tract stenosis had been treacted. 1 out 27 benign stenosis die from hepatic failure, others convalesce. Only 1 out 7 survival with malignant cholangioma exist 4 years long, others die from cancer recurrence from 8 monthsto 24 months. Conclusion Using intraoperative B - mods ultrasonography and cholangiography, operator can accurately locate the stenosis or tumour. find out tumour size and stenosal area and the ayntopie with portal vein and hepatic artery, can areduce massive blood lossing and abate paratherapeutic damage increase probability of success in carcinectomy. effects are exeellent.