中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (06): 697-701.DOI: 10.19538/j.cjps.issn1005-2208.2023.06.18

• 论著 • 上一篇    下一篇

非离断式Roux-en-Y吻合技术在胆肠吻合术中应用研究

杜小军，江新华，万玉玲，毛    卫，焦磊明   

  1. 南昌市第九医院普外科，江西南昌330002 
  • 出版日期:2023-06-01 发布日期:2023-06-17

  • Online:2023-06-01 Published:2023-06-17

摘要： 目的    探讨非离断式（Uncut） Roux-en-Y吻合技术在预防胆肠吻合术后反流性胆管炎中的临床价值。方法    收集南昌市第九医院2014—2021年间所有各种原因行胆肠吻合术的病例46例，其中行Uncut Roux-en-Y胆肠吻合术者12例（简称U组）；行常规Roux-en-Y胆肠吻合术者34例（简称R组），比较两组手术耗时、术中出血量、术后肛门恢复排气时间、术后首次进食时间、术后住院天数、总住院费用、术后胆红素、术后并发症（包括胆肠或肠肠吻合口漏、腹腔出血、腹腔感染、切口感染、肺部感染、Roux滞留综合征、反流性胃炎、反流性胆管炎等）等指标。结果    U组在手术总耗时、术中出血、术后肛门恢复排气时间、术后首次进食时间、术后住院天数、术后胆红素、总住院费用等指标均优于R组；在术后并发症指标上两组之间差异无统计学意义。结论    Uncut Roux-en-Y胆肠吻合术相对传统的Roux-en-Y胆肠吻合术，具有手术操作简单易行、耗时短、术后恢复快等优点，便于基层医院推广，有临床应用价值。

关键词: 胆肠吻合术, 非离断式Roux-en-Y胆肠吻合术, Roux-en-Y胆肠吻合术, 胆汁反流, 胆管炎

Abstract: Clinical application of Uncut Roux-en-Y anastomosis in choledochojejunostomy:A single-institution experience     DU Xiao-jun, JIANG Xin-hua, WAN Yu-ling, et al. The Ninth Hospital of Nanchang,  NanChang 330002, China
Corresponding author: MAO Wei,E-mail:montdavid@163.com
Abstract    Objective    To investigate the clinical value of Uncut Roux-en-Y anastomosis in the prevention of reflux cholangitis after choledochojejunostomy. Methods    A total of 46 patients who underwent choledochojejunostomy in The Ninth Hospital of Nanchang from 2014 to 2021 were collected, including 12 patients who underwent Uncut Roux-en-Y choledochojejunostomy（Group U）,34 patients underwent conventional Roux-en-Y choledochojejunostomy（Group R）, Compared two groups of the operation time, intraoperative blood loss, postoperative anal exhaust time, postoperative time of food intake, postoperative hospital stay and total hospitalization expenses, postoperative bilirubin level, postoperative complications（including biliary intestinal or bowel intestinal anastomotic leakage and abdominal bleeding, abdominal cavity infection, infection of the incision, pulmonary infection, Roux stasis syndrome, reflux gastritis, reflux cholangitis, etc.）. Results    Group U was superior to Group R in total operation time, intraoperative bleeding, postoperative anal exhaust time, postoperative first feeding time, postoperative hospital stay, postoperative bilirubin level, and total hospitalization costs. In terms of postoperative complications, there were no significant differences between the two groups. Conclusion    Compared with the traditional Roux-en-Y choledochojejunostomy, Uncut Roux-en-Y choledochojejunostomy has the advantages of simple operation, short time consumption, quick postoperative recovery, which is convenient for promotion in Basic-level hospitals and has clinical application value.

Key words: choledochojejunostomy, Uncut Roux-en-Y choledochojejunostomy, Roux-en-Y choledochojejunostomy, bile reflux;cholangitis