中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (04): 307-308.

• 论著 • 上一篇    下一篇

Ⅲ、Ⅳ型肝门胆管癌切除术空肠前唇与肝面吻合应用价值研究

杜希臣,金星林   

  1. 延边大学附属医院肝胆胰外科, 吉林延吉133000
  • 出版日期:2010-04-01 发布日期:2010-04-06

  • Online:2010-04-01 Published:2010-04-06

摘要:

目的    探讨空肠前唇与肝面吻合在Ⅲ、Ⅳ型肝门胆管癌切除术中应用的安全性和实用性。方法    2004年6月至2009年6月间,延边大学附属医院肝胆胰外科对23例获得根治性Ⅲ、Ⅳ型肝门胆管癌切除的病人行术中空肠后唇与肝内胆管后壁吻合后,距吻合口附近空肠内置引流管,空肠戳孔引出。空肠前唇与肝脏面吻合,先在肝面结扎之后用其一根线重新穿引小圆针,于空肠前唇黏膜层进针浆肌层出针给予结扎。结果    1例发生胆肠吻合口漏,无一例术后出现吻合口出血和胆肠吻合口狭窄。完成吻合平均时间20min。结论    空肠前唇与肝面吻合的方法简易、安全、实用。

关键词: Ⅲ、Ⅳ型肝门胆管癌, 淋巴结清扫, 胆漏

Abstract:

Effect of the biliary drainage reconstruction by jejunal foreside to hepatic parenchyma on the Ⅲ Ⅳtype hilar cholangiocarcinoma       DU Xi-chen, JIN Xing-lin. Department of Hepatobiliary, Yanbian University Hospital, Yanji 133000, China
Corresponding author:JIN Xing-lin, E-mail:xljin@ybu.edu.cn
Abstract    Objective    To study the technique for anastomosis of jejunal forepart with hepatic parenchyma on the Ⅲ,Ⅳtype hilar cholangiocarcinoma. Methods    Twenty-three patients with advanced Ⅲ, Ⅳ type hilar cholangiocellular carcinoma underwent radical resection with jejunum rearside to bile duct rearside between June 2004 and June 2009 at the Department of Hepatobiliary of Yanbian University Hospital. In the cavity of jejunum near anastomosis drainage tube was laid and fetched out. Then hepatic parenchyma to jejunal foreside was sewed up. Results    Only one patient occurred anastomotic leakage. None of the patients developed anastomotic blooding and stenosis. The duration for accomplishing the anastomosis was 20 minutes averagely. Conclusion    The techniqe of the biliary drainage reconstruction by jejunal foreside to hepatic parenchyma on the hilar cholangiocarcinoma can be safe and used routinely.

Key words: Ⅲ Ⅳ type hilar cholangiocarcinoma, lymphadenectomy, biliary leakage