先天性胆管囊性扩张症(附64例报告)

The treatment of Congenital Choledochocyst (A Report of 64 Cases)

报告经手术治疗的先天性胆管囊性扩张症６４例，以探讨最佳术式及疗效。其中急诊行外引流术１３例，术后１１例行囊肿切除术，效果满意；行单纯内引流术１２例，术后死亡２例，随访的５例均经常有胆道感染表现；行囊肿切除、胆道重建或肝叶切除５２例，随访４２例，优良率９２．６％。提示：囊性扩张的胆管切除、胆道重建是治疗先天性胆管囊性扩张症的最有效方法；单纯内引流术远近期并发症多，且术后可能发生癌变，无论急诊或择期手术均应避免使用。

Sixty-four patients with congenital choledochocyst treated by surgery were reported in this paper. Thirteen patients treated with external biliary drainage emergently, then eleven of them underwent cystotectomy plus internal biliary drainage with good results. Tweleve patients subjected to internal biliary drainage. Two patients died after operation; five patients were followed up, all of whom had repeat biliary infections. Fiftytwo patients underwent cystotectomy plus biliary reconstruction or partial hepatotectomy, 42 of whom were followedup, with a successful rate 92.6%. The results suggested that the most effective method for congenital choledochocyst was cystotectomy plus biliary reconstruction. Internal biliary drainage alone had a high complication rate and a possibility of postoperative malignant change. Both in emergency and elective operative conditions, this procedure should be avoided.