摘要
目的探讨腹腔镜下再次胆肠吻合在治疗良性胆肠吻合口狭窄(BBEAS)中的可行性和有效性。方法采用回顾性病例对照研究。2017年1月至2019年6月,11例行开放手术后BBEAS病人再行腹腔镜下再次胆肠吻合术治疗(腹腔镜组),同期有13例BBEAS病人接受经皮经肝穿刺胆道引流(PTCD)+球囊扩张治疗(PTCD组)。对比两组病人一般资料、治疗相关参数及随访结果。结果腹腔镜组诊断BBEAS时间晚于PTCD组,余术前资料两组类似。两种方式治疗BBEAS的成功率(10/11 vs.12/13,χ^2=0.15,P=0.9)及相关并发症发生率(1/10 vs.11/57,χ^2=0.5,P=0.48)类似,但腹腔镜组在治疗所需中位时间(14 d vs.161 d,Z=-3.5,P=0)、所需平均治疗次数(1.0次/例vs.4.4次/例,T=-6.4,P=0)明显少于PTCD组。术后随访26.0±10.8个月,两组吻合口狭窄复发比例(1/10vs.4/12,χ^2=1.7,P=0.19)差异无统计学意义。结论腹腔镜下再次胆肠吻合术治疗良性胆肠吻合口狭窄安全、效果良好。
ObjectiveTo analysis the feasibility and efficiency of laparoscopic redo bilioenteric anastomosis forbenign bilioenteric anastomotic stricture(BBEAS).MethodsRetrospective case control study was used.From theJanuary 2017 to the June 2019,11 patients with BBEAS underwent laparoscopic redo hepaticojejunsotmy in the FirstHospital of Xi’an Jiaotong University(laparoscopic group);While 13 patients,who received percutaneous transhepaticcholangiodrainage(PTCD)and balloon dilation at the same period,were enrolled in the controlled group(PTCD group).The data,including demographic factors,procedure-related results and follow-up,were compared.ResultsThe datawere comparable in two groups,excepting the onset time of BBEAS in laparoscopic group was significantly later.Theclinical successful rate(10/11 vs.12/13,χ^2=0.15,P=0.9)and incidence of complications(1/10 vs.11/57,χ^2=0.5,P=0.48)were similar in two groups,but the laparoscopic group needed much less treatment duration(14 d vs.161 d,Z=-3.5,P=0)and procedure times per patients(1 vs.4.4,T=-6.4,P=0).After an average follow-up of 26.0±10.8 months,the stricturerecurrence ratio was similar in two groups(1/10 vs.4/12,χ^2=1.7,P=0.19).ConclusionLaparoscopic redohepaticojejunostomy issafe and effective for BBEAS.
作者
李宇
张军强
王铮
仵正
吕毅
刘学民
LI Yu;ZHANG Jun-qiang;WANG Zheng;LIU Xue-min(Department of Hepatobiliary Surgery,the First Hospital of Xi’an Jiaotong University,Xi’an 710061,China;不详)
出处
《中国实用外科杂志》
CSCD
北大核心
2020年第11期1314-1319,共6页
Chinese Journal of Practical Surgery
关键词
腹腔镜
胆肠吻合狭窄
二次手术
经皮经肝胆道引流
狭窄复发
laparoscopy
benign bilioenteric anastomotic stricture
re-operation
percutaneous transhepatic cholangiodrainage
stricture recurrence
