远端悬吊空肠胆总管十二指肠吻合术15例的基础及临床研究

中国医师进修杂志 Pub Date : 2001-03-15 DOI:10.3760/CMA.J.ISSN.1673-4904.2001.03.010

Zeng Dacai, W. Ping, L. Guanghua, Cai Yunfeng, L. Weimin

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引用次数: 0

摘要

目的:胆十二指肠反流是空肠介入胆十二指肠吻合术(IJC)中尚未解决的问题。为了解决这个问题，我们设计了带远端悬挂的IJC (IJCDS)。方法:将25 cm的间接性空肠远端插入悬挂于约2.5 cm长的十二指肠腔内。术中、术后测定胆道压力及胆汁生化成分，并进行比较。术后行钡餐及T管胆道造影。还进行了后续调查。结果:术后胆道压力明显下降。虽然病人改变了许多姿势，但钡餐未发现胆管-十二指肠反流。T管胆道造影显示空肠麻痹或穿插，造影剂持续推入十二指肠。在随访调查中发现14例非反流性胆管炎和结石复发。结论:黄芪多糖对预防胆管-十二指肠反流有较强的作用。另一方面，它避免了其他防反流手术方式的缺点。因此在临床推广应用方面具有良好的前景。

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BASAL AND CLINICAL RESEARCH ON INTERPOSED JEJUNAL CHOLEDOCHODUODENOSTOMY WITH DISTAL SUSPENDING:15 PATIEWTS REPORT

Objective:Cholangioduodenal reflux is still an unresolved problem in interposed jejunal choledochoduodenostomy (IJC) yet.To settle this problem,we designed IJC with distal suspending (IJCDS).Methods:IJCDS is to insert and suspend the distal end of the 25 cm-ling interposed jejunum to the duodenal cavity,which is about 2.5 cm long.The pressure of the biliary tract and the biochemical composition or the bile were measured during and after the operation and the results were compared.Barium meal and cholangiography through T tube were performed after the operation.Follow-up surveys were also done.Results:The pressure or the biliary tract decreased distinctively after the operation.Barium meals found no cholangioduodenal reflux although the patients had changed many postures.Cholangiography through T tube showed parisaltic or the interposed jejunum and the contrast medium was continuously pushed into the duodenum.Noreflux cholangitis and stone recurrence were found in the follow-up survey in 14 patients.Conclusion:IJCDS has the powerful function on preventing cholangioduodenal reflux.On the other hand,it avods the shortcomings of other reflux-preventing operative pattern.So it had the good prospect to extend its clinical usage.

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来源期刊

中国医师进修杂志

自引率

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发文量

26239

期刊介绍： Chinese Journal of Postgraduates of Medicine (founded in 1978, monthly) is one of the series of journals of the Chinese Medical Association (CMA) under the supervision of the National Health Commission of the People's Republic of China, sponsored by the Chinese Medical Association (CMA) and Dalian Institute of Theoretical Medicine (DITM). It is a core journal of Chinese science and technology, a statistical source journal of Chinese scientific and technical papers, and a statistical source journal of China Academic Journal Impact Factor Annual Report. The journal adheres to the purpose of using continuing medical education and post training, highlights new theories, new knowledge, new methods and new technologies, and focuses on the combination of theory and practice, and the combination of popularisation and improvement. Main columns: Special tutorials, expert forums, clinical treatises, clinical experience, reviews and lectures, continuing medical education, teaching and research, advanced training forum, drugs and clinics, overview of progress, introduction of new technologies, imaging and clinics, lessons learnt, discussions and evaluations, case reports, discussions of clinical cases, conference proceedings, and domestic and international academic developments. The main target readers are clinical medical personnel in internal medicine, surgery, gynaecology, paediatrics and ophthalmology.