镍钛记忆合金辅助胆肠吻合治疗复杂手术后胆道狭窄的再认识

目的 进一步评价镍钛记忆合金辅助胆肠吻合治疗复杂的手术后胆道狭窄的价值。方法 随访分析1994年6月以来，采用镍钛记忆合金支撑胆肠吻合口治疗的9例复杂手术后胆道狭窄，并与此前及同期同类病例非镍钛记忆合金治疗病例作比较。随访期均超过2年。结果 前期常规治疗8例中2例疗效优，3例疗效一般，3例疗效差。直管治疗7例，其中6例疗效优，1例效果差。同期常规治疗5例，4例疗效优，1例差。Y形管治疗2例，疗效均差。结论 有选择地应用直管镍钛形状记忆合金辅助胆肠吻合术式可以提高复杂的手术后胆管狭窄的疗效；Y形镍钛形状记忆合金目前还不具有实用价值。

Re-evaluation of shape-memory nitinol alloy endoprosthesis in assisting Roux-en-Y hepaticojejunostomy for management of postoperative biliary stricture

Objective To re evaluate TiNi endoprosthesis in assisting Roux en Y hepaticojejunostomy for management of postoperative biliary stricture. Methods Nine cases of complicated postoperative biliary stricture treated with the TiNi endoprothesis in combination with Roux-en-Y hepaticojejunostomy 2 years ago were followed up and compared with those similar cases treated or had been treated without TiNi. Results Of the 8 cases routinely treated before June 1994, 2 showed good outcome, 3 medium and 3 poor. Amongst the 7 cases treated with straight TiNi stent, 6 showed good outcome and 1 poor. Both of the 2 cases treated with Y shaped TiNi stent showed poor outcome. For the 5 cases routinely treated at the same period of time, 4 showed good outcome and 1 poor. Conclusions The prognosis of the complicated postoperative biliary stricture can be improved by selective application of straight TiNi stent in combination with Roux-en-Y hepaticojejunostomy, and the Y-shaped TiNi stent is of no applicable value at present.