先天性胆总管囊肿切除后不同胆道重建术的疗效

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目的评价先天性胆总管囊肿切除后不同胆道重建术的疗效.方法对行囊肿切除、肝总管空肠Roux-en-Y吻合重建胆道的106例先天性胆总管囊肿病例进行回顾性分析和随访复查.结果在106例重建的胆道中,胆支空肠袢套叠瓣成形37例,矩形瓣成形21例,未做抗反流瓣48例.获随访61例,平均4.82年.无1例发生吻合口狭窄;逆行性胆道感染4例(矩形瓣组1例,未做抗反流瓣组3例),2例再手术并于胆支空肠袢套叠瓣成形后症状消失;偶有腹痛症状8例,其中未做抗反流瓣组5例,矩形瓣成形组2例,套叠瓣成形组1例.结论在先天性胆总管囊肿切除后胆道重建中,肝总管空肠Roux-en-Y吻合加胆支空肠袢套叠瓣成形术符合胆道生理、能有效预防术后胆道反流和吻合口狭窄.
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