JOURNAL OF CLINICAL SURGERY ›› 2019, Vol. 27 ›› Issue (3): 236-238.doi: 10.3969/j.issn.10056483.2019.03.019
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Objective:To explore a reasonable surgical treatment for Oddi sphincter relaxation complicated with recurrent choledocholithiasis.Methods:342 patients with choledocholithiasis complicated with Oddi sphincter relaxation disease(all underwent several biliary operations,including cholecystectomy) to receive surgical treatment in cholangiopancreatic surgery were selected as research object.According to the surgical treatment in different ways,these patients were divided into three groups:bile duct transection + RouxenY anastomosis(group Ⅰ,281 cases),holedocholithotomy and T tube drainage by laparotomy or endoscopy(group Ⅱ,40 cases),ERCP operation(group Ⅲ,21 cases),compared with three groups of different surgical methods of treatment.Results:The calculi recurrence rate and the incidence of cholangitis in Ⅰ group were significantly lower than that in Ⅱ group and Ⅲ group(P<0.05),and the average recurrence time was significantly later than that of Ⅱ group and Ⅲ group(P<0.05),while there was no significant difference between Ⅱ group and Ⅲ group about the calculi recurrence rate,recurrence of cholangitis rate and average time(P>0.05).The total effective rates of cholangioenterostomy was significantly higher than that of choledocholithotomy and ERCP(P<0.05),while there was no significant difference between the total effective rate of choledocholithotomy and ERCP(P>0.05).Conclusion:Transection of bile duct and bile duct RouxenY anastomosis is an effective surgical treatment for Oddi sphincter relaxation combined with recurrent bile duct stones.
Key words: sphincter of Oddi laxity, recurrent bile duct stones, cholangitis, choledochojejunostomy
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