牟云川 黄世华 翟勋

[摘要] 目的 探究胆肠Roux-en-Y吻合术治疗先天性胆总管囊肿的疗效及术后并发症的处理。 方法 选择2009年3月～2015年5月我院收治的先天性胆总管囊肿患者38例进行研究，将其随机均分为研究组和对照组。其中研究组19例，采取胆肠Roux-en-Y吻合术治疗；对照组19例，采取空肠间置肝管十二指肠吻合术进行治疗。术后比较分析两组患者的围术期各项指标、术后并发症的发生情况及术后远期疗效。 结果 治疗后研究组手术时间、术后开始进食时间、住院时间等明显短于对照组，差异有统计学意义（P<0.05）。两组的住院费用、并发症发生率比较，差异无统计学意义（P>0.05）。研究组远期疗效的优良率（100.00%）明显高于对照组的优良率（68.42%），两组比较差异有统计学意义（u=2.4629，P=0.0138）。对照组患者出现6例反流性胆管炎，研究组为0例，两组比较差异有统计学意义（P<0.05）。 结论 胆肠Roux-en-Y吻合术是治疗先天性胆总管囊肿的一种较为可靠有效的治疗方案，值得临床大力推广应用。

[关键词] 胆肠Roux-en-Y吻合术；先天性胆总管囊肿；空肠间置肝管十二指肠吻合术；并发症

[中图分类号] R575.7 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0020-03

Bilioenteric Roux-en-Y anastomosis effects and treatment of the complications of congenital bile duct cysts

MOU Yun-chuan HUANG Shi-hua ZHAI Xun

Department of General Surgery，the First People′s Hospital of Zhaotong City in Yunnan Province，Zhaotong 657000，China

[Abstract] Objective To investigate bilioenteric Roux-en-Y anastomosis curative effect and treatment of the complications of congenital bile duct cysts. Methods 38 patients with congenital bile duct cysts form March 2009 to May 2015 in our hospital were studied，who were randomly divided into study group and control group.The study group were taken bilioenteric Roux-en-Y anastomosis，the control group were taken between ileocecal hepatic duct anastomosis for treatment.The perioperative indicators，incidence of postoperative complications and postoperative comparative of long-term effect between two groups were analysed and compared. Results After treatment，the operative time and hospital stay was significantly shorter than that of the control group respectively，the start eating after surgery of the study group significantly earlier than the control group，with statistical difference（P<0.05）.The occurrence of both hospital costs and complications of the two groups，there was no significant difference（P>0.05）.Study group of excellent long-term efficacy rate（100.00%） was significantly higher than that of the good rate （68.42%） in the control group，the two groups was statistically significant（u=2.4629，P=0.0138）.The control group of patients was 6 cases of reflux cholangitis，and the study group was 0 cases，the difference was statistically significant（P<0.05）. Conclusion Bilioenteric Roux-en-Y anastomosis is a treatment programs of more reliable and effective in congenital bile duct cysts，and it is worth promoting and clinical applications.

[Key words] Bilioenteric Roux-en-Y anastomosis；Congenital；Ileocecal set between hepatic duct anastomosis；Complication

先天性胆总管囊肿即胆总管扩张，是一种先天性肝胆系统囊肿疾病，多见于女性患者。该病的临床特征主要表现为胆总管的梭状扩张或囊肿[1]。在囊肿切除的基础上，胆肠Roux-en-Y吻合术和空肠间置肝管十二指肠吻合术是目前治疗该病的主流方案[2]。然而这两种手术方式各有千秋，还有待进一步研究。本文旨在探究两种手术的治疗效果。

1 资料与方法

1.1 一般资料

选择2009年3月～2015年5月我院收治的先天性胆总管囊肿患者38例进行研究，将其随机均分为研究组和对照组。该研究已向我院伦理委员会提出申请并得到批准，且所有研究患者均知情并签署了相关协议。……