先天性胆总管囊肿的诊治体会

Experience in Diagnosis and Treatment for Congenital Choledochocyst

目的通过对47例先天性胆总管囊肿诊疗的回顾性分析提出理想的手术方法。 方法全部病例采用囊肿切除加胆肠吻合术重建胆道。 结果 随访46例,其中24例采用短段空肠间置,同时加抗返流术式者20例;22例行Roux—Y肝总管空肠吻合术,同时加抗返流术式17例,均疗效满意,而加抗返流术式者疗效更优。 结论 先天性胆总管囊肿的诊疗,应明确囊肿的分型及胆胰解剖,采用囊肿彻底切除,再行胆肠重建时应加抗返流术式。

Objective The experience in dignosis and treatment for choledochocyst was summarized respectively, in order to formulate an ideal operation scheme. Methods The biliary tract of all patients with choledochocyst was reconstructed by cyst removal plus choledochoduodenostomy. Results The 46 cases were followed up, 24 cases were treated with a short segment jejunum replacement plus anti -reflux operation, 22 cases were Roux -Y hepaticojejunostomy, 19 of them, the remoral combined with anti-reflux operation was carried out simultaneously. The therapeutic effect of all cases was satisfactory, especially in the patients with antiflux operation. Conclusions Definite the typing and anatomy of biliary duct and pancreas are very important in the diagnosis and treatment of choledochal cyst, we consider that all cysts should be removed thoroughly, then an anti-reflux operatiqn should be added in the reconstruction of biliary tract. Doing so the efficacy could be better.