2017•Chin Arch Gen Surg(Electronic Edition)Requires access
Clinical observation of improved Roux-en-Y choledochojejunostomy in obstructive jaundice patients with history of abdominal surgery
Zefeng Zhan, Wei Chen, Jianwen Hong, Xin Huang, Jianqun Lin
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Abstract
Objective
To investigate the effectiveness, safety and advantages of the improved Roux-en-Y choledochojejunostomy in obstructive jaundice patients with history of abdominal surgery.
Methods
From August 2006 to December 2016, two hundred and thirty-one patients with obstructive jaundice who had history of abdominal surgery and underwent the choledochojejunostomy were analyzed retrospectly. The patients were divided into traditional group (128 cases) and modified group (103 cases) according to the operation mode. The completion time of the biliary jejunal anastomosis, amount of bleeding, return of the flatus after the operation, hospital stay after the operation, resolution of jaundice and complications were observed between two groups.
Results
Compared with the traditional group, the time of intestinal anastomosis, amount of intraoperative bleeding, postoperative hospital stay and recovery time of intestinal function were significantly shorter in the modified group, the difference was statistically significant (t=11.882, 3.726, 7.332, 12.076, all P<0.01). There was no significant difference in serum total bilirubin level between the two groups before operation (t=-0.663, P=0.507). The serum total bilirubin levels decreased gradually at 1, 3 and 7 d after operation, the level in the modified group was significantly lower than that in the traditional group, with better effect of reducing jaundice (F=4.384, P=0.043). The incidence of postoperative complications was significantly reduced in the modified group (11.7% vs 39.1%, χ2=21.841, P<0.01), and the long-term effect was similar to that of the traditional group (χ2=0.009, P=0.925).
Conclusion
For obstructive jaundice patients with history of abdominal surgery, the improved Roux-en-Y choledochojejunostomy is a safe and effective method, which is not only easy to operate, but also beneficial to postoperative rehabilitation.
Key words:
Portoenterostomy, hepatic; Jaundice, obstructive; Medical history taking; Abdominal surgery