The Long-term Effect Follow-up Studies Of The Anastomosis By Intervening Ileocecus Between Hepatic Duct And Duodenum

ObjectiveBy analyzing the long-term complications of treating congenital choledochal cysts between Roux-en-Y choledochojejunostomy and biliary reconstruction by intervening ileocecus,to further estimating the long-term effect and anti regurgitation capacity of treating congenital choledochal cysts utilizing biliary reconstruction by Intervening ileocecus,and providing reference for clinical application in the future.MethodsSummarized and long-term follow-up observed to patient datas of utilizing biliary reconstruction by Intervening ileocecus in Affiliated hospital of taishan medical university in 1990.10-2009.01.The study group contains 27 patients utilizing biliary reconstruction by Intervening ileocecus,and the control group contains 19 patients utilizing Roux-en-Y choledochojejunostomy.By consulting medical records of two groups patients,do comparative analysis to perioperative indexes of two groups patients,including:operation time,starting eating time,length of hospital stay,hospitalization cost;Second,do comparative analysis to postoperative complications of two groups patients,including:bile leakage,infection of incision,seroperitoneum,pleural effusion,urinary system infection.Finally,by reviewing the patient's follow-up data,do analysis and comparison to long-term complications of two groups patients,including:canceration,postoperative reflux cholangitis,anastomotic stenosis,secondary stones,and making evaluation to the long-term curative effect of patients.Using SPSS20.0 statistical software to analyze datas,and confounding factors analysis using Logistic regression analysis,when P<0.05,the differences have statistical significance;using mean±standard deviation(x±s)to show measurement data,and using t-test,when P<0.05,accounting for there are differences,and having statistical significance;the count datas of preoperative perioperative period and postoperation immediate-long-term use?~2-test,when P<0.05,accounting for there are differences,and having statistical significance;hierarchical datas use rank sum test analysis(Wilcoxon two samples comparison method),when P<0.05,accounting for there are differences,and having statistical significance.ResultsIn the indexes of operation time,starting eating time and length of hospital stay,the results of two groups are all P<0.05 in the perioperative period,so we can account for there have significant differences,and the operation time,starting eating time and length of hospital stay of study group are longer than the control group.The difference of hospitalization cost is no statistical significance(P>0.05).The difference of postoperative complications in the near future is no statistical significance(P>0.05).The long-term follow-up results:the satisfactory rate of study group is 100%,the control group is 89.47%.The datas have significant differences through the rank sum test analysis,P<0.05,so the long-term follow-up result of study group is superior than the control group.In the aspects of refluxing cholangitis incidence and anti regurgitation capacity,P<0.05,the datas have significant differences through the?~2-test analysis,so the anti regurgitation capacity of study group is superior than the control group.Conclusion1.Cyst resection is the basis of the treatment of congenital choledochal cysts,and selecting biliary reconstruction operation with superior anti regurgitation is the key to improve the long-term curative effect.2.Anti regurgitation result of biliary reconstruction by intervening ilecocecus is reliable,and it is a relatively safe and reliable and effective therapeutic schedule as the treatment of congenital choledochal cysts,and it could be as the solution for patients with?-type choledochal cystic expansion or?-type cyst>2cm or?b-type extrahepatic bile duct multiple cysts,and it is worthy of energetically popularization and application in clinic.