腹腔镜外科杂志2025，Vol.30Issue(8)：589-594,6.DOI:10.13499/j.cnki.fqjwkzz.2025.08.589
腹腔镜下改良袢式胆肠吻合术的临床应用与疗效分析
Clinical application and efficacy analysis of laparoscopic modified loop choledochojejunostomy
摘要
Abstract
Objective:To investigate the feasibility and clinical efficacy of laparoscopic modified loop choledochojejunostomy,and to evaluate its application value in shortening operative time and reducing complications.Methods:A retrospective analysis was conducted on clinical data of 124 patients who underwent laparoscopic choledochojejunostomy from Jan.2021 to Dec.2024.Patients were divided into a modified group(n=58)and a traditional group(n=66)according to the surgical technique.The modified group received laparoscopic modified loop choledochojejunostomy,in which the jejunal limb was lifted through an antecolic route to the porta hepatis,followed by end-to-side choledochojejunostomy.The jejunum was transected approximately 5 cm from the anastomosis site while preserving the jejunal mesenteric blood supply,and side-to-side jejunojejunostomy was completed about 50 cm distally.The traditional group underwent conventional laparoscopic Roux-en-Y choledochojejunostomy.Perioperative parameters and postoperative complications were compared between the two groups.Results:The choledochojejunostomy time in the modified group was significantly shorter than that in the traditional group[(37.98±4.54)min vs.(47.55±6.24)min,P＜0.001].No statistically significant differences were observed between the two groups in terms of intraoperative blood loss,postoperative hospital stay,delayed gastric emptying,reflux cholangitis,or total complication rate.There was no significant difference in anastomosis time between BMI＞25 kg/m2 subgroup and ≤25 kg/m2 subgroup in the modified group(P＞0.05),whereas the anastomosis time was significantly prolonged in the BMI＞25 kg/m2 subgroup of the traditional group(P=0.002).Conclusions:Laparoscopic modified loop choledochojejunostomy is safe and feasible,significantly shortens choledochojejunostomy time,and is conducive to postoperative recovery.It is suitable for obese patients and is wor-thy of clinical promotion.关键词
改良袢式胆肠吻合术/腹腔镜检查/吻合术,Roux-en-Y/肥胖症Key words
Modified loop choledochojejunostomy/Laparoscopy/Anastomosis,Roux-en-Y/Obesity分类
医药卫生引用本文复制引用
陈熙,蒋婷,匡铭,胡朝辉,罗华..腹腔镜下改良袢式胆肠吻合术的临床应用与疗效分析[J].腹腔镜外科杂志,2025,30(8):589-594,6.基金项目
绵阳市卫健委科研课题(201926) （201926）
四川省卫健委微创适宜技术基地课题(2022JDXM018) （2022JDXM018）
