先天性胆总管扩张症38例分析

Analysis of 38 cases of congenital choledochus cyst

目的研究胆总管扩张症的正确诊断与治疗方法。方法回顾性分析1985年1月至2004年1月我科手术治疗的38例先天性胆总管扩张症患者的资料,术后平均随访50个月。结果行胆总管十二指肠吻合术2例,胆总管空肠Roux-Y吻合术9例,行胆总管扩张部切除加肝总管空肠Roux-Y吻合术27例;术后胆瘘3例,胰瘘并腹腔出血各1例,无手术死亡。结论胆总管扩张部切除加胆肠Roux-Y吻合是本病的主要治疗方法,疗效好,局限性肝内胆管扩张可行部分肝叶切除术。

Objective In order to discuss the diagnosis and treatment of adult congenital choledochal cysts. Methods To analyse 38 cases with congenital choledochal cysts from January 1985 to January 2004.The average time of following-up was 50 months. Results Two patients were operated with cystoduodenostomy,9 with Roux-en-y cystojejunsotomy,27 with resection of cyst with Roux-en-y hepaticojejunsotomy. Biliary fisfula happened in three patients, intraperitioneal hemorrhage in one patient, pancreatic fistula in one patient. No patient was died during operation. Conclusion Resection of the cyst with Roux-en-y hepaticojejunostomy bring in fine effect. Hepatolobectomy is fit for the patients with local cystic lesion of the liver.