The Clinical Application Of Cholangio-Enterostomy With Elementary Stapler In The Treatment Of Benign Extra-Bile Duct Obstructive Jaundice

Objective To investigate the value of applying Roux-Y side-to-side choledochojejunostomy with elementary stapler in the treatment of benign extra-bile duct obstructive jaundice and provide scientific evidence.Methods Review 112 patients with benign extra-bile duct obstructive jaundice applied with cholangio-enterostomy include Roux-Y side-to-side choledochojejunostomy with elementary stapler, Roux-Y side-to-side choledocho-jejunostomy, end-to-side choledocho-jejunostomy, choledocho- duodenostomy in the 9th Affiliated Hospital of Guangxi Medical University from April 2004 to March 2008,then follow up and analyze the items include the surgery time, the amount of bleeding within the operation, drainage volume after the operation, enterocinesia time after the operation, complications.Results 1. On the surgery time, the group Roux-Y side-to-side choledochojejunostomy with elementary stapler(98.00±13.13min) is shorter than Roux-Y side-to-side choledochojejunostomy(135.10±15.69min) and end-to-side choledocho-jejunostomy(129.04±10.33min),but longer than choledocho- duodenostomy (79.77±7.88min). The group Roux-Y side-to-side choledocho- jejunostomy with elementary stapler has the significant difference with the other three groups(P<0.05).2. Enterocinesia time after the operation of the group Roux-Y side-to-side choledocho-jejunostomy with elementary stapler(24.58±8.66min) is shorter than the other groups. Enterocinesia time after the operation of the group Roux-Y side-to-side choledochojejunostomy with elementary stapler has statistical significance with the other three groups(P<0.05). 3. The incidence of complications such as flow of gall(3%) and anastomotic stenosis(3%) of the group Roux-Y side-to-side choledochojejunostomy with elementary stapler is lower than the other three groups. The group Roux-Y side-to-side choledochojejunostomy with elementary stapler has the significant difference with the other three groups(P<0.05). But on haemobilia,ascending infection and recurrence, Roux-Y side-to-side choledochojejunostomy with elementary stapler has no statistical significance with the other three groups(P>0.05). 4. The group Roux-Y side-to-side choledochojejunostomy with elementary stapler has no statistical significance with the other three groups(P>0.05)on the amount of bleeding(201.30±14.81ml) within the operation and drainage volume (80.03±10.11ml) after the operation.Conclusion 1.Roux-Y side-to-side choledochojejunostomy with elementary stapler has the advantage in the treatment of benign extra-bile duct obstructive jaundice for shorter enterocinesia time after the operation, resolving anastomotic stenosis, lessen the incidence of complications include flow of gall and anastomotic stenosis, and more suitable for cases which common bile duct location deeper, more difficult used with traditional practices suture.2. The group Roux-Y side-to-side choledochojejunostomy with elementary stapler is shorter than Roux-Y side-to-side choledochojejunostomy and end-to-side choledochojejunostomy, but longer than choledochoduodenostomy. But comparing with the higher incidence of complications of the latter, Roux-Y side-to-side choledochojejunostomy with elementary stapler is more worthful. 4. Roux-Y side-to-side choledochojejunostomy with elementary stapler is belong to safety margin comparing with traditional operations for it does not increase the trauma during operation.