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中国临床研究:2025,38(5):710-714
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胆肠吻合术后胆道相关并发症的防治研究现状
(昆明医科大学第二附属医院肝胆胰外科,云南昆明 650101)
Diagnosis and treatment of biliary-related complications after biliary-enteric anastomosis
(Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China)
摘要
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投稿时间:2024-10-28   网络发布日期:2025-05-20
中文摘要: 肝胆管 -空肠行 Roux.en.Y吻合术(BEA)为治疗各种胆道相关的良恶性疾病常用的恢复胆汁通畅引流的重建术式。然而,术后胆道相关并发症(BRCs)的发生率仍然较高,文献报道发生率为 8%~27%。常见的 BRCs有胆道出血、术后胆漏、胆道感染、术后吻合口狭窄、围肝门肝内外胆管结石、胆源性肝脓肿等。 BRCs发生的影响因素众多且复杂,因此需要从多角度予全面考虑。关于胆道重建的研究仍在继续推进,重点是改善 BEA的治疗效果,降低近期和远期 BRCs的发生率。本文回顾了近年相关文献,探讨了 BEA术后 BRCs的病理机制、诊疗现况及危险因素概述,以期为 BEA围手术期防治术后 BRCs提供参考。
Abstract:Hepatobiliary-jejunal Roux-en-Y anastomosis (biliary-enteric anastomosis, BEA) is a widely utilized reconstructive procedure for restoring bile flow in the treatment of various benign and malignant biliary diseases. However, the incidence of biliary-related complications (BRCs) remains relatively high, with reported rates in the literature ranging from 8% to 27%. Common BRCs include biliary bleeding, postoperative bile leakage, biliary tract infection, postoperative anastomotic stricture (PAS) , intra- and extrahepatic bile duct stones at the porta hepatis, and biliary liver abscesses. The factors influencing the occurrence of BRCs are numerous and complex, requiring comprehensive consideration from multiple perspectives. Research on bile duct reconstruction continues to evolve, with an emphasis on enhancing the outcomes of BEA and reducing the incidence of BRCs in both the near and distant future. This article reviews the relevant literature from recent years and summarizes the pathogenesis, current treatment status, and risk factors associated with postoperative BRCs after BEA, aiming to provide a reference for the prevention and management of these complications during the perioperative period of BEA.
文章编号:     中图分类号:R735.8    文献标志码:A
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引用文本:
束保昆,刘锋,陈鹏.胆肠吻合术后胆道相关并发症的防治研究现状[J].中国临床研究,2025,38(5):710-714.

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