new anastomosis method for choledochojejunostomy by the way behind antrue pyloricum

作     者：YANG Xin-wei YANG Jue WANG Kui ZHANG Bao-hua SHEN Feng WU Meng-chao 

作者机构：Eastern Hepatobiliary Surgery Hospital Second Military MedicalUniversity Shanghai 200438 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2013年第24期

页      面：4633-4637页

核心收录：

学科分类：090603[农学-临床兽医学] 0710[理学-生物学] 07[理学] 09[农学] 0906[农学-兽医学] 071006[理学-神经生物学] 

主　　题：cholangitis choledochojejunostomy anastomosis, prognosis 

摘      要：Background Reflux cholangitis has been the most common In this study we intended to evaluate the perioperative and choledochojejunostomy. complication after Roux-en-Y choledochojejunostomy. long-term efficacy of a new anastomosis method for Methods Clinical data of 143 eligible patients who underwent choledochojejunostomy in the Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University, China between January 2007 and December 2010 were retrospectively analyzed. Among the patients, 38 consecutive cases underwent this new anastomosis method for choledochojejunostomy （improved group, IG） and 105 underwent standard Roux-en-Y choledochojejunostomy （control group, CG）. Changes in the incidence of cholangitis, the time of beginning to eat liquid meals, post-operative delayed gastric emptying and liver function between the two groups were compared. Results There was no statistical difference in the levels of alanine transaminase, alkaline phosphomonoesterase and gamma-glutamy transferase between the two groups. The time of beginning to eat liquid meals was significantly shorter in IG than CG （P 〈0.05）. The incidence of delayed gastric emptying was lower in IG than CG, with statistical tendency between the two groups （P=0.052）. Among nine patients with different degrees of acute cholangitis in the two groups, one patient （2.6%） in IG and eight （7.6%） in CG suffered from acute cholangitis within six months of follow-up after discharge, but with no statistical difference between the two groups （P 〉0.05）. Of the nine patients with acute cholangitis, none in IG and four in CG were hospitalized for further treatment （P 〉0.05）. Conclusions Patients in IG had satisfactory perioperative and long-term prognosis with shorter time of beginning to eat liquid meals and lower incidence of delayed gastric emptying. This new procedure of choledochojejunostomy by the way behind antrue pyloricum was easy and safe to perform with no mortality and low complicat