胆总管十二指肠吻合术后胆管炎再手术19例分析

目的 探讨胆总管十二指肠吻合术后胆管炎的外科治疗方法.方法 回顾性分析19例胆总管十二指肠吻合术后胆管炎的病因、病理、再次手术方法和效果.结果 13例行原位拆建术,10例效果优良,3例好转;4例改行胆管空肠Roux-Y吻合,3例优良,1例好转;空肠间置胆总管十二指肠吻合1例,效果优良;胃窦切除、胃空肠Roux-en-Y吻合1例,好转.结论 合理的再次手术,可以有效治疗胆总管十二指肠吻合术后顽固性胆管炎.

Reoperation for cholangitis after choledochoduodenostomy: a report of 19 cases

Objective To investigate the operative treatment of reversion cholangitis after chole-dochoduodenostomy. Methods The reasons, pathology, treatment and outcome of reversion cholangi-tis after Choledochoduodenostomy in 19 patients were retrospectively analyzed. Results Anastomosis dismantled and reconstructed originally was performed in 13 cases. The outcome was excellent in 10cases and better in 3. Four cases revised to Roux-Y cholangiojejunostomy and it was excellent in 3 and better in 1. One patient revised to JICD and the outcome was excellent. One patient underwent partial gastrectomy and Roux-en-Y gastrojejunostomy and the symptom was better. Conclusion The rational reoperation may effectively ameliorate the symptoms of pertinacious cholangitis after choledochoduode-nostomy.