皮下通道型胆囊肝胆管成形术治疗肝胆管结石 和胆管狭窄的临床研究

目的：总结皮下通道型胆囊肝胆管成形术的临床效果。方法：统计了1994年以来我院76例行STHG手术患者的适应症、临床效果及术后早期并发症。并选择同期实施的125 列行传统胆肠吻合（CJ）的患者进行对照。结果：STHG的手术适应症与传统胆肠吻合基本相同；STHG组患者的手术时间、住院时间、术中出血量明显少于CJ组，术后恢复良好，仅2例次并发症。结论；该术式既保存了胆囊及Oddi括约肌功能，又保证了胆汁的生理流向；防止了肠液的反，所以避免了消化功能紊乱，防止了反 流性胆管炎，对患者的影响小，是一种较为理想的治疗肝胆管结石和肝门胆管狭窄的术式。

Clinical effects of subcutaneous tunnel and hepatocholangioplasty with the use of gallbladder in the treatment of hepatocholelithiasis and biliary stenosis.

Objective To summarize the clinical effects of subcutaneous tunnel and hepatocholangioplasty with the use of gallbladder(STHG)in the treatment of hepatocholelithiasis and biliary stenosis.Methods The data on the indications,clinical effects and complications of STHG performed on 76 patients from Dec.1994 to June 2001 were collected and analyzed.The medical records of one hundred and twenty five patients who submitted to conventional choledochojejunostomy(CJ)during the same period were selected for comparison.Results The indications of STHG were similar to those of CJ.Compared with the patients in CJ group,the patients who experienced STHG had shorter operation time,shorter hospitalization time,less bleeding,better recovery and less complications.Conclusion This operation(STHG) not only keeps the normal physiological function of gallbladder and Oddi sphincter,but also maintains the physiological way of bile fluid and prevents intestinal juice reflux.In this way,STHG can ward off the risk of dysfunction of GI tract and the occurrence of refluent cholangitis.So STHG is a novel and more satisfactory operation for hepatocholelithiasis and biliary stenosis.