关键词: 肝内胆管结石, 胆肠吻合术, 术后复发, 预防, 治疗

Abstract: Prevention and treatment of hepatolithiasis after biliary-enteric anastomosis        TONG Kui-nan, LIU Kun, GUO Wei. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Medical Research Center for Digestive Diseases, National Key Laboratory of Digestive Health, Beijing 100050, China
Corresponding author:GUO Wei,E-mail:guowei@ccmu.edu.cn
Abstract    Biliary-enteric anastomosis is a common procedure for the treatment of hepatolithiasis and biliopancreatic benign and malignant diseases. The recurrence of hepatolithiasis after biliary-enteric anastomosis or the formation of hepatolithiasis due to reflux cholangitis and anastomotic stricture are both challenging surgical clinical problems. Since the formation of reflux cholangitis and anastomotic stricture after the biliary-enteric anastomosis is complicated by many factors, the prevention, and treatment of recurrent hepatolithiasis after biliary-enteric anastomosis needs to be considered comprehensively from multiple perspectives. The fundamental principle is to achieve the requirements of “cleaning the stones, relieving the obstruction, removing the lesions, and facilitating the drainage”. The current common methods for treating intrahepatic bile duct stones after choledochojejunostomy include endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangial drainage (PTCD), percutaneous transhepatic cholangioscopy (PTCS), laparoscopic surgery (LC), and open surgery. The best treatment plan should be selected according to the specific situation of the patient, as much as possible to preserve the function of the bile duct and avoid repeated surgery and complications. With the advancement of medical technology and research, the prevention and treatment of intrahepatic bile duct stones after choledochojejunostomy will have better results and prospects.

Key words: hepatolithiasis, biliary-enteric anastomosis, postoperative recurrence, prevention, treatment