目的总结完全腹腔镜下胆管空肠Roux-en-Y吻合的适应证、禁忌证、技术要点、安全性、并发症的预防及治疗效果。 方法回顾性分析2008年6月至2013年12月期间于笔者所在医院科室接受腹腔镜下胆管空肠Roux-en-Y吻合术的67例患者的临床资料。 结果67例患者中，66例完全在腹腔镜下完成手术，1例于放置蓝蝶后在手助下完成。手术时间144～253 min，平均152 min；术中出血30～220 mL，平均70 mL；术后住院时间6～11 d，平均8.1 d；住院费用2.0～2.5万元，平均2.1万元。术后发生漏胆3例，均经引流后痊愈；术后无肠瘘、出血、腹腔感染、肠梗阻等发生。术后20例患者获访，随访时间5～20个月，中位数为13个月。随访期间发生胆管炎2例，无吻合口狭窄发生。 结论对胆总管囊肿、胆总管下端良性狭窄、胆总管结石伴胆管扩张、壶腹部周围癌等需行胆肠吻合患者施行腹腔镜胆总管空肠Roux-en-Y吻合术是可行的，其手术费用稍高，但患者术后恢复快，且具有微创优势。
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.