Comparison Of Efficacy Of Two Biliary Reconstructions In Treatment Of Choledochal Cyst

ObjectiveTo provide a reference for future clinical application of the two biliaryreconstructions, the present thesis takes an analysis and evaluation on thedifficulty of two surgical operations, the patients’ trauma, the surgical spent, theanti-reflux effect, the short-term and long-term therapeutic efficacy of biliaryreconstruction by ileocecus intervening and Roux-en-y choledochojejunostomyin treating congenital choledochal cyst.MethodsFrom October1988to December2012, biliary reconstruction byileocaecum intervening and Roux-y choledochojejunostomy were performed on38patients, who suffering the congenital choledochal cyst,including16patients whohad biliary reconstruction by ileocecus intervening surgery (Group A) and22patients who had Roux-en-y choledochojejunostomy (Group B). The thesis takesa review on the medical records of the38patients. Firstly,5factors includingoperative time, postoperative eating time, length of hospital stay, hospital cost,short-term complication rates were considered to make comparisons betweenGroup A and B. Moreover, the comparisons of anti-reflux capacity, long-termefficacy and long-term complication were analyzed, according to the follow-update. Among the aforementioned comparisons, measurement data use t test,while count data are compared using Fisher’s exact test, P <0.05is considered tohave statistical significance.ResultsAfter compared the length of hospital stay, hospital cost and postoperativecomplication rate of the two biliary reconstructions, we draw a statisticalconclusion that there is no difference between them (P>0.05). The result ofpaired samples t test concerning the factors of operative time and postoperative eating time shows a distinction between them (P<0.05). Besides, a comparisonabout anti-reflux capacity, refluxing cholangitis and long-term efficacy is made to showthat biliary reconstruction by ileocecus intervening is superior to Roux-en-ycholedochojejunostomy (P<0.05).Conclusion(1)Choosing the biliary reconstruction which having strong anti-refluxcapacity is the key to improve the long-term efficacy in treating congenitalcholedochal cyst.(2)The simple patient prefer the biliary reconstruction by ileocecusintervening, for this operation has an advantage of strong anti-reflux capacity.While the patient in complex should choose the Roux-y choledochojejunostomywhich is simply and little trauma.(3)In case of postoperative blind side, the implement of various of biliaryreconstructions should ensure that the choledochoenterostom is wide and it isbetter to use biliary-enteric end-to-end anastomosis.