【摘要】 目的探讨胆肠吻合术后再次手术的原因及处理方式。方法对22例院内外行Roux-Y胆肠吻合病人进行回顾性分析。结果肝内胆管结石伴扩张12例,肝内胆管结石伴吻合口狭窄5例,吻合口狭窄3例,慢性胰腺炎1例,胆管癌1例。再次手术行吻合口扩张整形后重新吻合13例,行肝叶切除术并取石3例,行空肠袢切开取石3例,行肝叶切除加吻合口扩张整形重新吻合2例,胆肠侧侧吻合改为端侧吻合1例,胆道下端通畅拆除胆肠吻合1例。12例随访,2例间断发生胆管炎。结论肝内胆管残留病变和吻合口狭窄是再次手术的主要原因。胆肠吻合手术选择应慎重、治疗应彻底。更多还原

【Abstract】 Objective To explore the management of reoperation after cholangioenterostomy.Methods The reoperative data of 22 patients were introduced.Results There were 12 cases of intrahepatic stone and expression,5 cases of intrahepatic stone and anastomotic strictur,3 cases of anastomotic strictur.1 case of chronic pancreatitis,1 cases of cholangiocarcinoma.13 cases were subjected to reanastomosis after enlarging the primary anastomsis.3 cases were subjected to hepatic resection.3 cases hepatic resection were withdrawed by jejunum.2 cases were ubjected to hepatic resection and reanastomosis.1 case side-to-side anastomos changed to end-to-side anastomos.1 case cholangioenterostomy was demolished.12 cases were follow-uped,2 cases cholangitis broke out interruptly.Conclusions Intrahepatic biliary disease and joint narrow were major reason of reoperation.We should perform cholangioenterostomy carefully and thoroughly.更多还原