摘要
目的 探讨先天性胆管囊肿再次手术的原因和外科处理要点。方法 对 15年间收治的先天性胆管囊肿 12 0例进行分析 ,其中 5 3例为再次手术者。按Todani分型法 ,Ⅰ、Ⅳa、Ⅳb、Ⅴ型各有 33、14、2、4例。首次手术为单纯囊肿外引流术 17例 ,行囊肿十二指肠吻合术 8例 ,囊肿空肠Roux en Y吻合术 2 2例 ,行囊肿切除并胆道重建术 2例 ,行不规则手术 4例。结果 首次手术后主要并发症是慢性胆管炎、胆结石和胆系癌变者 (10例 )。再次手术以拆除原囊肿十二指肠或空肠吻合、再行囊肿切除并胆道重建为主要术式 (46 /5 3) ,已切除囊肿者以解决胆肠吻合口狭窄为重点。结论 胆管囊肿手术处理不当出现多种并发症是导致再次手术的主要原因 ,囊肿切除。
ObjectiveTo analyze the causes of and principles for reoperation of congenital choledochal cyst (CCC).MethodsDuring the period of 1986 to 2000, 120 cases of CCC were admitted to our unit,53 of them underwent reoperation. There were 33/14/2/4 cases respectively in Todani Type of Ⅰ/Ⅳa/Ⅳb and Ⅴ. First operation included simple external drainage in 17 cases, choledochoduodenostomy in 8 cases, and choledochojejunostomy with Roux en Y loop in 22 cases etc.ResultsPostoperative complications after external or internal drainage were cholangitis and hepatolithiasis, and high incidence of biliary carcinoma 19% (10/53). The mode of reoperation was mainly cyst excision with Roux Y hepaticojejunostomy (46/53).Conclusions Inappropriate surgical management of CCC incurred much complications that necessitated a reoperation. Cyst excision with reconstruction of the biliary tree by a Roux Y anastomosis is recommended as the therapy of choice for reoperation for patient with CCC.
出处
《中华普通外科杂志》
CSCD
北大核心
2002年第5期265-266,共2页
Chinese Journal of General Surgery
关键词
先天性胆管囊肿
再次手术
癌变
Choledochal cyst
Surgical procedures, operative
Canceration
