Published by Misasa Medical Center, Okayama University Medical School
Published by Misasa Medical Center, Okayama University Medical School

<Formerly known as>
岡大三朝分院研究報告 (63号-72号) 環境病態研報告 (57号-62号)
岡山大学温泉研究所報告 (5号-56号) 放射能泉研究所報告 (1号-4号)

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肝管空腸吻合により救命しえた重症閉塞性黄疸の1例

野一色 泰晴 岡山大学温泉研究所リハビリテーション医学部門
小竹森 通明 岡山大学温泉研究所リハビリテーション医学部門
古元 嘉昭 岡山大学温泉研究所リハビリテーション医学部門
仲原 泰博 岡山大学温泉研究所リハビリテーション医学部門
抄録
Jejuno hepatic ducts anastomoses were successfully performed by carefull managements. Because of dense adhesion at hilus of liver, around the gall bladder and choledocus, dissection of common duct, cystic duct, hepatic ducts and even gall bladder was very difficult anatomically. Resecting a inflammatory granulative tumor, including gall bladder, choledocus, lesser omentum and hepatocluodenal ligament en mass, we found that only very short hepatic ducts with inflammatory granulation tissue were remained open. Reconstruction of biliary passages was done using Roux. Y. method with loop jejunum. It needed very carefull procedure to avoid suture failure, ascending infection (cholangitis) and postoperative stenoses at the site of the anastomoses. The anastomoses were performed using atraumatic 3-0 Tefdek ; interrupted and each big bite of duct wall together with surrounding thickend granulative tissue, in order to keep capillary blood supply effective and to minimize the anastomotic trauma which were very important for wound healing. Patient is healthy, enjoying his normal life and his liver function tests are within normal range, 1 1/2 years postoperatively.
備考
原著論文 (Original Paper)
ISSN
0369-7142
NCID
AN00032853