摘要
目的探讨成人型先天性胆管扩张症的外科诊断与治疗。方法回顾性分析我院1998年4月-2007年4月间21例成人型先天性胆管扩张症的临床资料。结果21例中有不同程度的上腹痛17例。行B超检查19例，CT10例，MRCP8例，确诊率100％，1例囊肿癌变病人术前MRCP误诊为囊肿并发结石。手术20例，其中2例Ⅱ型患者行囊肿切除胆总管T管引流术，其余行一期或二期囊肿切除、肝管空肠Roux-en-Y吻合术。术后胰瘘1例，其余疗效满意，全组无围手术期死亡病例。结论上腹痛是成人先天性胆管扩张症最常见的临床表现；影像学检查是诊断该病的主要依据；成人型胆管扩张症手术治疗的关键在于手术方式和手术时机的选择，囊肿切除、肝管空肠Roux-en-Y吻合术为首选术式。
Objective To investigate the diagnosis and surgical treatment of congenital biliary dilatation in adults. Methods The clinical data of 21 adult patients with congenital biliary dilatation admitted from April of 1998 to April of 2007 were analyzed retro- spectively. Results 17 cases had different degree of epigastric pain.B ultrasound was performed in 19 cases, CT in 10 cases and MRCP in 8 cases, and the accuracy was 100%. 1 case with cyst malig-nancy was misdiagnosed as calculus by MRCP. Twenty cases underwent surgical therapy. Total excision of cyst plus closure of common bile duct over T-tube was performed for 2 type Ⅱ cases. Primary or secondary resection of cyst with Roux-en-Y hepaticojejunostomy was used in the others. There was 1 case complicating with pancreatic leakage, no perioperative mortality occurred in whole group. Conclusion Epigastric pain is the most frequent clinical manifestation of congenital biliary dilatation in adults. Imaging examinations are mainstay in diagnosis of the disease. The key point to surgical treatment of congenital biliary dilatation in adults is the operating methods and opportunity and excision of cyst with Roux-en-Y hepaticojejunostomy has been regarded as the first operation choice.
出处
《肝胆外科杂志》
2007年第5期333-335,共3页
Journal of Hepatobiliary Surgery
关键词
先天性胆管扩张症
成人
诊断
治疗
congenital biliary dilatation
adult
diagnosis
treatmen
