先天性胆总管囊肿17例临床分析

Clinical Analysis of Congenital Choledochocyst in 17 Cases

报道１７例先天性胆总管囊肿病人，最常见的临床表现为腹痛１００％，间歇性黄疸３５５％，腹块１１８％，无１例有上述典型三联症诊断主要依靠Ｂ超、ＰＴＣ及ＥＲＣＰ手术方式主要为：囊肿部份切除空肠Ｒｏｕｘ－Ｙ吻合，囊肿切除空肠Ｒｏｕｘ－Ｙ吻合，前者并发症达４０％，癌变率占１０％；后者近远期疗效满意结果表明：先天性胆总管囊肿的手术治疗应尽可能切除胆总管囊肿；困难者可大部切除，但应避免残留囊腔过大，保证内引流口在囊肿最低位，减少胆汁潴留及反复感染。

Reported were 17 cases of congenital choledochocyst. The most common clinical presentations were abdominal pain (100%), intermittent jaundice (35.5%) and abdominal mass (11.8%), with no typical 3-in-one-combined symptom of the above. The diagnosis depended on B-ultrasound, PTC and ERCP. The surgical plans mainly included partial cyst resection plus jejunostomosis and complete cyst resection plus choledochojejunostomy. The former revealed a complication rate of 40% and a cancerization rate of 10% while the latter produced satisfactory short- or long-term effects. In the surgical treatment of congenital choledochocyst, as the results showed, the cyst should be resected as much as possible, but be resected partly in the case of difficulty. The residual cyst cove should not be left too large and the anostomosis should be at the lowest position so as to avoid cholestegosis and repeated inflammation and to reduce the rates of calculus and cancerization.