【摘要】 目的比较胆肠改良襻式吻合术与Roux-en-Y吻合术的疗效。方法收集139例行胆肠改良襻式吻合术及120例行胆管空肠Roux-en-Y吻合术胆道重建患者的临床资料,比较其手术时间、术中出血量、肠道功能恢复时间及出院时间,并观察2组间术后并发症的差异。结果与胆管空肠Roux-en-Y吻合术组比较,胆肠改良襻式吻合术组的手术时间更短,患者术中出血更少、肛门排气时间及住院时间均更短(P均<0.05)。术后出现胆汁漏在胆肠改良襻式吻合术组为4例(2.9%),低于Roux-en-Y吻合术组的13例(10.8%),P<0.01。术后2组患者的急性胆管炎和胃排空障碍发生率比较差异均无统计学意义(P均>0.05)。结论胆肠改良襻式吻合术更符合生理,术后恢复较快,发生胆汁漏出风险较低,优于胆管空肠Roux-en-Y吻合术。更多还原

【Abstract】 Objective To compare the clinical efficacy between modified uncut jejunal loop anastomosis and Roux-en-Y choledochojejunostomy. Methods Clinical data of 139 patients undergoing modified uncut jejunal loop anastomosis and 120 receiving Roux-en-Y choledochojejunostomy were retrospectively analyzed.The operation time,intraoperative hemorrhage volume,the time of intestinal function recovery,discharge time and postoperative complications were statistically compared between two groups. Results Compared with patients undergoing Roux-en-Y choledochojejunostomy,intraoperative hemorrhage was significantly reduced and the operation time,time of first flatus and length of hospital stay were significantly shortened in the modified uncut jejunal loop anastomosis group( all P < 0. 05). In the modified uncut jejunal loop anastomosis group,the incidence of bile leakage was 2. 9%( n = 4),significantly lower compared with 10. 8%( n = 13) in the Rouxen-Y choledochojejunostomy group( P < 0. 01). The incidence of acute cholangitis and delayed gastric emptying did not significantly differ between two groups( both P > 0. 05). Conclusion Compared with Roux-en-Y choledochojejunostomy,the modified uncut jejunal loop anastomosis yields better physiological status,faster postoperative recovery and lower incidence of cholangitis.更多还原