螺旋CT及术中胆管造影在先天性胆管扩张症诊疗中的作用

SPIRAL COMPUTERIZED TOMOGRAPHY AND INTRAOPERATIVE CHOLANGIOGRAPHY IN THE DIAGNOSIS AND TREATMENT OF CONGENITAL BILIARY DILATATION

目的探讨螺旋CT及术中胆管造影在先天性胆管扩张症诊疗中的作用。方法对2004年1月～2009年1月来我科手术治疗的先天性胆管扩张症病儿65例进行分析、总结。全部病例术前均行螺旋CT检查和术中胆管造影检查,以辅助指导手术的具体操作。结果CT检查显示,65例中囊肿型42例(其中并发肝内胆管不同程度扩张或狭窄15例),梭状型23例。60例获得清晰的胆管造影图像,胰胆管共同通道过长46例,胰胆管合流角度异常4例,迷走胆管2例。全组病儿术后7～12d治愈出院。结论螺旋CT及术中胆管造影有助于指导先天性胆管扩张症,特别是并发特殊病变病儿的具体手术操作的施行。

Objective To investigate the role of spiral computerized tomography （SCT） and intraoperative cholangiography （IC） in the diagnosis and treatment of congenital biliary dilatation. Methods The data of 65 patients with congenital biliary dilatation （CBD） treated surgically, from Jan. 2004 to Jan. 2009, were analyzed and summarized. All the patients underwent preoperative SCT and intraoperative IC, to guide specific performance at surgery. Results Of 65 cases, cyst-type was found in 42 on SCT （15 cases with different extent intrahepatic bile duct dilatation or stenosis） and fusiform in 23. A clear cholangiogram was obtained in 60 patients, in which, an excess pancreaticobiliary common passage was noted in 46 cases, anomalous angle junction of pancreaticobiliary duct in four and aberrant bile-duct in two. All the sick children were cured and discharged on day 7-12 postoperatively. Conclusion Spiral CT and intraoperative cholangiography are helpful in detection and therapy of congenital biliary dilatation, especially for the patients with special conditions.