간담도 결석에서 총수담관 - 십이지장 문합술과 총수간관 - 공장문합술의 비교

• Published in: The Korean journal of gastroenterology Vol. 24; no. 5; pp. 1103 - 1108
• Main Authors: 이연희, 조남천, 윤광수, 김대성, 노병선, Yeon Hee Lee, Nam Cheon Cho, Kwang Soo Yoon, Dae Sung Kim, Byoung Seon Rhoe
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 01.01.1992
• Subjects: Choledochoduodenostomy; Hepaticojejunostomy
• ISSN: 1598-9992

Over the last ten years, various nanoperative procedures including endoscopic papillotomy reduced the number of patients who underwent surgery for bile duct stones, and the procedure of choledo- choduodenostomy (CD) disappeared from the surgical practice in many centers. Consequently Hepaticojejunostomy (HJ), which has been used in cancer surgery, is preferred more and more, even in benign disease. But some authors still favor the use of CD, because it is less time-consuming than HJ and does not preclude further endoscopic exploration. So the question arises which type of biliary enteric anastomosis is preferable when a choice is possible. We obtained the following results; CD was performed in 27 patients and HJ in 38 patients. The male to female ratio was 1: 2.3, and the age incidence was most commonly distributed in 5th decade. The duration of operation was 168 minutes in CD, 327 minutes in HJ and 261 minutes on the average. The length of hospital stay was 18 days in CD, 25 days in HJ and 22 days on an average. CD was performed for CBD stones (55.6%), CBD & IHD stones (18.5%), IHD stones (14.8%), and GB, CBD & IHD stones (11.1%). HJ was performed for the CBD & IHD stones (42.1%), IBD stones (26.3%), GB, CBD & IHD stones (21.1%) and CBD stones (10.5%), The postoperative complication rate was 38.5% and there was no difference between CD and HJ in early complications. In late camplications, CD revealed the remnant stones (6 cases), recurrent stones (4 cases) and anastomosis site stricture (2 cases), whereas HJ revealed remnant stones (2 cases) and no anastomosis site stricture. There was no operative mortality.