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目的 验证肝管十二指肠吻合粘膜乳头成型术的抗返流作用。方法 16只犬被分为3组 :A组行肝管十二指肠吻合粘膜乳头成型术 ;B组行胆囊空肠Roux en Y吻合术胆支肠管加抗返流套叠瓣 ;C组行单纯胆囊空肠Roux en Y吻合术。术后测量 3种术式的胆道顺流压和逆流压。临床上采用囊肿切除 ,肝管十二指肠吻合粘膜乳头成型术治疗 13例胆总管囊肿患儿。结果 A组的逆流压明显高于B、C组 (P <0 0 1)。临床治疗 13例患儿 ,术后 2周有 1例出现胆道积气 ,4年后出现胆道返流症状并发胆管结石 ,余 12例经 3 5～ 7 5年随访 ,无任何不适的症状。结论 肝管十二指肠吻合粘膜乳头成型术具有并发症少及抗返流作用强等优点。
Objective To verify the anti-reflux effect of hepaticoduodenal mucosal papillary surgery. Methods Sixteen dogs were divided into three groups: group A received hepatic duct duodenal anastomosis and mucosal papilla; group B received Roux en Y gallbladder intestine plus antireflux nesting flap; group C was simple Gall jejunum Roux en Y anastomosis. Postoperative bile duct 3 kinds of surgical pressure and counter-pressure measurement. Clinical use of cyst excision, duodenal anastomosis mucosal papillary plastic surgery in 13 cases of children with choledochal cyst. Results The reflux pressure in group A was significantly higher than that in group B and C (P <0.01). Thirteen children were treated clinically. One patient developed bile duct gas after 2 weeks, and biliary reflux occurred 4 years later with bile duct stones. The remaining 12 patients were followed up from 35 to 75 years without any discomfort. Conclusions Hepatic duct duodenal anastomosis mucocutaneous papillary surgery has the advantages of less complications and anti-reflux effect.