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1、XX大學畢業(yè)論文膽管空腸RoumY吻合術后膽道感染發(fā)生的原因2014年6月25日膽管空腸Roux-Y吻合術后膽道感染發(fā)生的原因作者:鄧漾韓天權吳衛(wèi)澤王建承費健朱堅秦儉秦鈞田銳張圣道【摘要】H的探討膽管空腸Roux-Y吻合術后祖道感染的發(fā)生率及其原因。方法回顧研究1997年7月?2004年10月行祖管空腸Roux-Y吻合術62例,以及12例既往行膽管空腸Roux-Y吻合術,因膽道感染入我院再次手術的病例資料。結果62例中7例(占11.3%)岀現(xiàn)術后膽道感染,平均隨訪44」月,4例再手術,均發(fā)現(xiàn)膽管空腸Ro
2、ux-Y吻合口狹窄。有吻合口直徑資料56例,吻合口直徑<2.0cm的20例屮5例(占25.0%)出現(xiàn)術后膽道感染;直徑2.0cm,36例屮僅1例(占2.8%)出現(xiàn)祖道感染。在12例膽管空腸吻合術后膽道感染再次手術病例屮,發(fā)現(xiàn)原吻合口狹窄8例(占66.7%),吻合口以上膽管狹窄3例,1例空腸失功腸襟膽石性腸梗阻。結論膽管空腸Roux-Y吻合術后膽道感染的發(fā)生率較低;膽道引流不暢是膽管空腸Roux-Y吻合術后發(fā)生膽道感染的主要原I大I,吻合口狹窄是術后祖道引流不暢的重要因素?!娟P鍵詞】膽管空腸Roux-Y吻
3、合術;膽道感染;膽管結石AbstactObjeciveToprobetheincidenceandcausesofinfectionofbiliarytractafterbileductjejunumRoux-Yanastomosis.MethodsSixty-twocaseswithbileductjejunumRoux-Yanastomosis(fromJuly1997toOct2004)wereretrospectivelystudied.Post-operativebiliaryinfectio
4、nofthistypeofoperationweredocumented.OthertwelvecaseswithstomareconstructionandbiliaryinfectionafterbileductjejunumRoux-Yanastomosiswasalsoanalyzed?ResultsSevenepisodesofbiliaryinfection(11.3%)wereencountered.Meantimeoffollow-upwas44.1months.Therc-opcrat
5、ionwasperformedfor4patientsinourhospital.Constrictionofstomawasfoundinalleasesduringthercopcration?Fifty-sixpatientswithoperationrecordsofstomawerealsodividedintotwogroupsaccordingtodiameterofstoma:GroupA(<2.0cm)andgroupB(2.0cm).Fiveepisodesofbiliaryinfe
6、ctionwereencounteredingroupA,justoneepisodeofbiliaryinfectionwasencounteredingroupB.OthertwelvecasesofstomareconstructionandbiliaryinfectionafterbileductjejunumRoux-Yanastomosiswerealsodocumented.Eightcasesofstomaconstriction,threecasesofconstrictionofbi
7、leductabovestomaandonecaseofgallstoneobstructionofafferentloopofbileductjejunumRoux-Yanastomosiswereconfirmedduringsecondtimeofoperation.ConclusionsPost-operativeinfectionrateofbileductjejunumRoux-Yanastomosisislow.Inadequatebiliarydrainageisthemajorcaus
8、eofinfectionofbiliarytractafterbileductjejunumRoux-Yanastomosis.Stenosisofstomaisthemajorfactorofinadequtebiliarydrainage.KeywordsbileductjejunumRoux-Yanastomosis;biliarytractinfections;bileductstonesUH管空腸Roux-Y吻合術在治療多種膽?道