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首页> 外文期刊>Surgical Endoscopy >Laparoscopic choledochoduodenostomy An effective drainage procedure for recurrent pyogenic cholangitis.
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Laparoscopic choledochoduodenostomy An effective drainage procedure for recurrent pyogenic cholangitis.

机译：腹腔镜胆总管十二指肠吻合术是复发性化脓性胆管炎的有效引流方法。

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摘要

Background: This article reports the technical aspects of laparoscopic choledochoduodenostomy (LCD) in patients with recurrent pyogenic cholangitis (RPC) and the perioperative results are also evaluated. This is a retrospective review of a prospectively maintained database. Methods: Twelve patients diagnosed to have RPC with the absence of intrahepatic stricture were selected for LCD during the period from 1995 to 2002. The majority of our patients had repeated attacks of cholangitis and had already undergone multiple sessions of endoscopic and operative lithotripsy. The LCD was performed using a five-port approach with the patient lying in the supine position. The stones were first cleared through the longitudinal supraduodenal choledochotomy followed by construction of a side-to-side diamond-shaped anastomosis of at least 15 mm between the bile duct and the first part of the duodenum using 2/0 monocryl in the single-layer method. Results: During the period from 1995 to 2002, 12 patients with RPC underwent LCD. There were 3 male and 9 female patients with a mean age of 62 (40-77). The median operation time was 137.5 min (90-270) and the median postoperative stay was 7.5 days (5-20). All cases were successful using the laparoscopic approach. Average analgesic requirement post operation was 126 mg (50-200 mg) intramuscular pethidine. There was one postoperative bile leak, and this complication was settled by conservative measures. Upon a mean follow-up of 37.6 months (6-91), there was no recurrent attack of cholangitis or any evidence of sump syndrome in this group of patients. Conclusion: LCD is a safe and effective drainage procedure for patients with RPC. Complications are uncommon and postoperative results are promising.
机译：背景：本文报道了复发性化脓性胆管炎（RPC）患者的腹腔镜胆总管十二指肠造口术（LCD）的技术方面，并对围手术期效果进行了评估。这是对预期维护的数据库的回顾性审查。方法：从1995年至2002年，选择12例被诊断为RPC且无肝内狭窄的患者进行LCD手术。我们的大多数患者反复发生胆管炎，并且已经接受了多次内镜和手术碎石术治疗。使用五端口方法在患者仰卧的情况下执行LCD。首先通过纵向十二指肠上胆总管切开术清除结石，然后在胆管和十二指肠的第一部分之间使用单层2/0单眼在至少15 mm的侧面形成菱形吻合。方法。结果：在1995年至2002年期间，对12例RPC进行了LCD手术。男3例，女9例，平均年龄62岁（40-77岁）。中位手术时间为137.5分钟（90-270），中位术后住院时间为7.5天（5-20​​）。使用腹腔镜方法所有病例均成功。术后平均镇痛需要量为126 mg（50-200 mg）肌内哌替啶。术后有一次胆汁漏出，这种并发症通过保守措施得以解决。平均随访37.6个月（6-91），该组患者无胆管炎复发发作或积液综合征的任何证据。结论：LCD是RPC患者安全有效的引流方法。并发症并不常见，术后结果很有希望。

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