Clinical analysis on 32 cases of benign biliary-enteric anastomotic stricture treated by quadrate lobectomy combined with large-caliber cholangio-jejunostomy / 中华普通外科杂志

ABSTRACT

Objective:To evaluate liver quadrate lobectomy combined with large-bore cholangio-jejunostomy for the treatment of benign biliary-enteric anastomotic stricture.Methods:The clinical data of 32 patients undergoing liver quadrate lobectomy combined with large-caliber cholangio-jejunostomy were retrospectively analyzed. The bile drainage effect and postoperative complications were analyzed. And the clinical effects of different size of biliary-enteric anastomosis were compared.Results:The most common short-term complications were cholangitis (9.4%) and bile leakage (9.4%), and the most common long-term complications were reflux cholangitis (15.6%). No anastomotic restenosis, stone formation or canceration were found. During the follow-up period, the total bilirubin ( t=19.455, P=0.000), direct bilirubin ( t=18.479, P=0.000), alkaline phosphatase ( t=3.229, P=0.002) and γ-glutamyltranspeptidase ( t=3.057, P=0.003) level were significantly improved. The effect of bile drainage in patients with 2-3 cm diameter of biliary-enteric anastomosis was similar to that in patients with >3 cm diameter ( t=0.284, P=0.778). The incidences of cholangitis (χ 2=0.121, P=0.728), bile leakage (χ 2=0.121, P=0.728) and reflux cholangitis (χ 2=0.205, P=0.652) were no statistical difference in both groups. Conclusion:Liver quadrate lobectomy combined with large-caliber cholangio-jejunostomy is effective in the treatment of benign biliary-enteric anastomotic stricture. More than 2cm in diameter of the biliary-enteric anastomosis is enough.