T型管支撑法在胆肠吻合术中的应用价值

目的：探讨一种T型管支撑法在胆肠吻合术中的价值。方法：回顾性分析41例胆肠吻合术患者的临床资料。按随机分组原则分成T型管支撑胆肠吻合口组（研究组）及直接胆肠吻合组（对照组）两组,并随访1～2年,比较两组的减黄效果、胆漏及胆肠吻合口狭窄的发生率。结果：两组具有相同的减黄效果;术后胆漏发生率研究组明显低于对照组;术后第1年随访研究组胆肠吻合口狭窄率低于对照组（P〈0.05）,第2年随访两组无明显统计学意义（0.1〉P〉0.05）。结论：T型管支撑胆肠吻合口法能有效预防胆肠吻合术早期胆漏的发生,对远期胆肠吻合口狭窄的预防尚缺乏证据。

The Value of T-tube Stent Method in Choledochojejunostomy

Objective：To investigate the value of a T-tube stent method in choledochojejunostomy.Methods：Clinical data of 19 cases of T-tube stent choledochojejunostomy（study group）and 22 cases of choledochojejunostomy without T-tube stent（control group）were analysed and compared,the patients of the 2groups were followed-up for 1to 2years.The serum level of total bilirubin and the morbidity of Bile leakage and anastomotic stricture between the 2groups were compared.Results：The postoperative serum level of total bilirubin decreased to the same level in both groups（P〉0.05）.About the morbidity of Bile leakage,study group was significantly lower than the control group（P〈0.05）.After the first year of follow-up,about the morbidity of anastomotic stricture,study group was significantly lower than the control group（P〈0.05）,After the second year of follow-up,there was no statistically significant between study group and control group（0.1〉P〉0.05）.Conclusion：T-tube stent method anastomotic method can effectively prevent choledochojejunostomy early bile leakage,anastomotic stricture of long-term prevention lack of evidence.