【摘要】 目的:探讨Ⅲ段肝内胆管空肠吻合在肝门部恶性梗阻治疗中的价值。方法:15例肝门部胆管恶性梗阻患者,行左外叶Ⅲ段肝内胆管-空肠Roux-en-Y吻合。结果:所有患者术后血总胆汁酸水平迅速下降,总胆红素和直接胆红素水平随之下降,术后1周平均下降至45%-83%,8例患者术后1-2月拔除外引流管,4例术后终生带管,失访3例。随访患者术后生存时间4-13个月,平均9.2个月。结论:Ⅲ段肝内胆管空肠Roux-en-Y吻合可以有效解除肝门部恶性梗阻所致的黄疸及肝功能损害,且术后护理简单,生活质量良好,是值得推荐的肝门部恶性梗阻姑息治疗方法。更多还原

【Abstract】 Objective:To evaluate the clinical value of cholangioenteric anastomosis with intra-hepatic duct of segment Ⅲ in the treatment of hilar biliary obstruction (MBO).Method:Cholangioenteric anastomosis with intra-hepatic duct of segment Ⅲ in 15 patients with hilar cancer.For all of the patients,the tumors were unresectable according to the pre-and intra-operative assessment.So the cholangioenteric anastomosis were performed to the intra-hepatic duct of segment Ⅲ with the round ligament approach for the palliative treatment.Result:One week after operation total bile acid decreased markedly in all cases,and total and direct bilirubin decreased to 45-83% of the original levels.The live time of patients were 4-13months (average 9.2 months) in follow-up cases.Conclusion:The cholangioenteric anastomosis with intra-hepatic duct of segment Ⅲ can effectively relieve the jaundice and the liver functional damage of the patients suffer from the malignant hilar biliary obstruction.This bypass procedure offers the longer survival and better quality of life for this kind of patients.更多还原