胆肠Roux-en-Y吻合术、胆管修补＋T管引流术治疗复杂医源性胆道损伤的远期并发症比较

目的 比较胆肠Roux-en-Y吻合术与胆道修补＋T管引流术治疗复杂医源性胆道损伤的远期并发症发生情况的差异.方法 对64例复杂医源性胆道损伤患者分别行胆肠Roux-en-Y吻合术及胆道修补＋T管引流术治疗,比较两种术式的远期并发症发生率.结果 术后随访1～8年,行胆肠Roux-en-Y吻合术患者的术后胆漏、胆道狭窄、胆管炎、黄疸、胆道结石发生率明显低于行胆道修补＋T管引流术者（P均＜0.05）.结论 胆肠Roux-en-Y吻合术是治疗复杂医源性胆道损伤较好的术式,其术后远期并发症发生率低于行胆道修补＋T管引流术者,值得临床推广应用.

Comparison of long-term complications of Roux-en-Y anastomosis and bile duct repair with T tube drainage in the treatment of complicated iatrogenic bile duct injuries

Objective To compare the long-term complications of Roux-en-Y anastomosis and bile duct repair with T tube drainage of complicated iatrogenic bile duct injuries in two kinds of operation modes.Methods Sixty-four patients were separately treated with Roux-en-Y anastomosis and bile duct repair with T tube drainage,and then the long-term complication rates of two different operation modes of bile duct injuries were compared respectively.Results During the follow-up of 1-8 years,the incidence rate of long-term complications including bile leakage,biliary stricture,jaundice,cholangitis and biliary calculi was significantly lower with the treatment of Roux-en-Y anastomosis than that of bile duct repair with T tube drainage （all P ＜ 0.05）.Conclusions Complicated iatrogenic bile duct injuries is better to be repaired by Roux-en-Y anastomosis,and the incidence rate of long-term complications is less than that of bile duct repair with T tube drainage,which is worth the clinical promotion.