目的總結完全腹腔鏡下膽管空腸Roux-en-Y吻合的適應證、禁忌證、技術要點、安全性、并發癥的預防及治療效果。 方法回顧性分析2008年6月至2013年12月期間于筆者所在醫院科室接受腹腔鏡下膽管空腸Roux-en-Y吻合術的67例患者的臨床資料。 結果67例患者中，66例完全在腹腔鏡下完成手術，1例于放置藍蝶后在手助下完成。手術時間144～253 min，平均152 min；術中出血30～220 mL，平均70 mL；術后住院時間6～11 d，平均8.1 d；住院費用2.0～2.5萬元，平均2.1萬元。術后發生漏膽3例，均經引流后痊愈；術后無腸瘺、出血、腹腔感染、腸梗阻等發生。術后20例患者獲訪，隨訪時間5～20個月，中位數為13個月。隨訪期間發生膽管炎2例，無吻合口狹窄發生。 結論對膽總管囊腫、膽總管下端良性狹窄、膽總管結石伴膽管擴張、壺腹部周圍癌等需行膽腸吻合患者施行腹腔鏡膽總管空腸Roux-en-Y吻合術是可行的，其手術費用稍高，但患者術后恢復快，且具有微創優勢。
ObjectiveTo explore the endothelial cells from human peripheral blood and islet of rat co-transplantation under the renal capsule of diabetic nude mice to improve the survival and function of transplanted islet. MethodsThe endothelial cells from human peripheral blood(5×105)and freshly isolated rat islet cells were co-transplanted under the renal capsule of diabetic nude mice model, then the fasting blood glucose, body weight, peripheral blood C-peptide level, and intraperitoneal glucose tolerance test(IPGTT) were measured to evaluated the islet graft survival and function. ResultsCompared with the control group, the fasting blood glucose level significantly decreased(P < 0.01), peripheral blood C-peptide level rised(P < 0.01), and body weight increased(P < 0.01) of receptor nude mice in experience group, the IPGTT also improved. ConclusionThe endothelial cells from human peripheral blood and islet of rat co-transplan-tation can obviously improve the survival and function of transplanted islet of nude mice.