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Value of choledochoenterostomy in the treatment of hepatolithiasis and/or extrahepatic cholangiolithiasis
Pages: 32-35
Year: Issue:  1
Journal: Journal of Navy Medicine

Keyword:  HepatolithiasisCholedochoenterostomy;
Abstract: Objective To analyze the clinical value of Rou-en-y choledochoenterostomy in the treatment of hepatolithiasis and/or extrahepatic cholangiolithiasis .Methods A retrospective analysis of the 96 patients admitted into our hospital from January , 2004 to December , 2013 for the treatment of choledochoenterostomy was made .Those who failed to have medical follow-up were exclu-ded in the study .Results In the said 10 years, there were 96 patients who underwent choledochoenterostomy due to hepatolithiasis and/or extrahepatic cholangiolithiasis and had due medical follow-ups.Of the 96 cases, 13 cases had bile duct stone recurrence , 8 had re-surgery treatment and another 8 had recurrent cholangitis .The recurrent rates for those patients with the internal diameter of hepato-cystic duct larger or smaller than 2.5cm were respectively 3.3%(1/30)and 18.2%(12/66).There were significant differences in them, when comparisons were made between the 2(χ2 =3.884,P=0.049).The recurrent rate of Oddi sphincter relaxation was 3.0%(1/33), the recurrent rate of no Oddi sphincter relaxation was 18.8%(12/64).There was statistical significance , when comparisons were made between the 2 (χ2 =4.449, P=0.025).The recurrent rate in cases of the end-to-side cholangiojejunostomy was 8.1 (6/74), which was lower than that of the side-to-side cholangiojejunostomy 〔(31.8%(7/22) 〕, (χ2 =8.143, P=0.004).Before the implementation of choledochoenterostomy , the number of surgery , the stricture of the lower end hepatocystic duct and jaundice had no significant effect on the recurrence of biliary calculi .Conclusion For the patients with hepatolithiasis and/or extrahepatic cholangiolith-iasis, it was ascertained that the upstream stricture be released .When the indication of the Rou-en-y choledochoenterostomy was clear , choledochoenterostomy should be performed , so as to reduce the recurrent rate of biliary calculi to the largest extent .The end-to-side cholangiojejunostomy was considered as the relatively reasonable anastomosis .
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