摘要
Abstract
Objective: To investigate and discuss the surgical practice and technical improvement of totally laparoscopic Roux-en-Y hepaticojejunostomy.
<br> Methods: The clinical data of 25 patients undergoing modified totally laparoscopic Roux-en-Y hepaticojejunostomy between October 2011 and October 2014 were retrospectively analyzed. Of the patients, 10 cases were congenital choledochal cysts (type I), 2 cases were common bile duct stone with distal inlfammatory stricture, 6 cases were cancer in the head of the pancreas, 5 cases were distal bile duct cancer, and 2 cases were periampullary cancer.
<br> Results: Operation was successfully completed in all patients, with no need for open conversion. hTe operative time for choledochal cysts was (194.5±20) min and for obstructive jaundice caused by inlfammatory stricture or tumors was (120±23.5) min; the time for hepaticojejunal anastomosis was (18.4±3.3) min and for jejunojejunal anastomosis was (17.4±2.3) min; the intraoperative blood loss was (38.8±35.8) mL, time to ambulation was (2.0±0.9) d and to ifrst lfatus was (2.48±0.7) d, and the length of postoperative hospital stay was (7.96±1.9) d, respectively. Minor bile leakage occurred in one patient atfer operation, which ceased atfer prolonged drainage. Follow-up was obtained in 24 patients (96%) for 1-36 months, postoperative relfux cholangitis occurred in one patient, which was resolved by anti-infective treatment, and no relapse of jaundice was noted in any of the cases. Conclusion: Totally laparoscopic Roux-en-Y hepaticojejunostomy is safe, effective, and feasible, and technical improvement can reduce the surgical difficulty, simplify the surgical procedure and shorten the operative time.关键词
胆管肠吻合术,肝/吻合术,Roux-en-Y/腹腔镜Key words
Portoenterostomy, Hepatic/Anastomosis, Roux-en-Y/Laparoscopes分类
医药卫生
