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目的探讨空肠前唇与肝面吻合在Ⅲ、Ⅳ型肝门胆管癌切除术中应用的安全性和实用性。方法2004年6月至2009年6月间,延边大学附属医院肝胆胰外科对23例获得根治性Ⅲ、Ⅳ型肝门胆管癌切除的病人行术中空肠后唇与肝内胆管后壁吻合后,距吻合口附近空肠内置引流管,空肠戳孔引出。空肠前唇与肝脏面吻合,先在肝面结扎之后用其一根线重新穿引小圆针,于空肠前唇黏膜层进针浆肌层出针给予结扎。结果1例发生胆肠吻合口漏,无一例术后出现吻合口出血和胆肠吻合口狭窄。完成吻合平均时间20min。结论空肠前唇与肝面吻合的方法简易、安全、实用。
Objective To investigate the safety and practicability of jejunum anterior lip and liver anastomosis in the resection of type III and IV cholangiocarcinoma. Methods From June 2004 to June 2009, 23 patients with radical type III and IV hilar cholangiocarcinoma resected in the hepatobiliary and pancreatic surgical department of Affiliated Hospital of Yanbian University underwent anastomosis of the posterior lip of the jejunum with the posterior wall of the intrahepatic bile duct , Near the anastomotic drainage tube built jejunum, jejunum poke hole leads. The jejunum anterior lip and the liver surface anastomosis, first ligation of the liver surface with a thread to re-lead through the small needle in the jejunum anterior lip mucosa into the needle to give the needle ligation. Results One patient had choledochojejunostomy and none had anastomotic bleeding and cholangiojejunostomy stenosis after operation. The average time to complete anastomosis 20min. Conclusions The method of anastomosis between jejunum anterior lip and liver surface is simple, safe and practical.