小儿先天性胆管扩张症的诊断与处理(附25例报告)

DIAGNOSIS AND TREATMENT OF CONGENITAL BILIARY DILATATION IN CHILDREN ( REPORT OF 25 CASES )

报告25例小儿先天性胆管扩张症的诊断与处理经验。结合文献指出大部分囊肿型扩张经超声检查即可确诊。诊断比较困难的是梭形扩张,此型需行ERCP和(或)术中胆道造影检查。对合并胆管炎的重症患儿,行根治手术前可先行超声导引下经皮囊肿穿刺外引流。囊肿远端切除困难时可采用Saing氏囊内切除法,在胆道重建方法中Roux-en-Y肝管空肠吻合法较肝管十二指肠间短段空肠间置法简便、有效。

In this paper,we report on 25 children with congenital dilatation of the bile duct. According to our experience and a review of the literature, cystic type biliary diliatation can mostly be detected by ultrasonography, but the diagnosis of lusilorm type is rather difficult. An investigation by endoscopic retrograde cholangiopancreaticography ( ERCP ) and/or intraop-erative cholangiography should be recommeded in the catter condition. On the severe patients complicated by cholangitis, ultrasound-guided percutaneous transcystic external drainae may be performed before definitive opra-tion. When excision of the distal end of the cyst is difficult, the Saing's method oi endocystic excision is useful. Among the methods of reconstruct-ruction of qile duct, the Roux-en-Y hepaticojejunostomy is easier and more reliable than the short jejunal segment hepatico-duodenal interposition.