管型消化道吻合器在胆管空肠Roux-en-Y吻合术中的应用

摘要

目的 总结管型消化道吻合器在胆管空肠吻合术中的应用经验. 方法 应用管型消化道吻合器行胆管空肠Roux-en-Y吻合术43例,包括胆总管结石合并胆总管下端炎性狭窄21例,肝内外胆管结石11例,胆总管下端癌1例,壶腹周围肿瘤7例,先天性胆总管扩张症2例,医源性胆总管损伤1例. 结果 本组手术时间平均75(60～90)min,胆肠吻合时间平均13(10～20)min,无吻合口瘘、胆道出血、胆肠吻合口狭窄等并发症,无围手术期死亡病例. 结论 应用管型消化道吻合器行胆管空肠Roux-en-Y吻合,安全可靠,缩短了手术时间,提高了手术效率及安全性.%Objective To assess the experience on application of circular digestive tract stapler in the Rouxen-Y anastomosis.Method A total of 43 cases were performed Roux-en-Y anastomosis with circular digestive tract stapler,including 21 cases of choledocholith combined with inflammatory stenosis of distal common bile duct,11 cases of intra-and extrahepatic bile duct calculi,1 case of distal common bile duct carcinoma,7 cases of periampullary neoplasms,2 cases of congenital choledochus dilatation and 1 case of iatrogenic common bile duct injury.Results The operative duration was 60 to 90 minutes (average 75 minutes),and the anastomosis time was 10 to 20 minutes(average 13 minutes).No complications such as anastomotic stoma fistula,biliary tract hemorrhage and anastomotic stenostomia were found.No perioperative death occurred.Conclusion Application of circular stapler is safe and reliable in Roux-en-Y anastomosis with shortening of operation duration and improvement of the surgical efficiency and safety.