胆囊切除术后残余病变的诊断和再手术治疗

THE DIAGNOSIS AND SURGICAL REOPERATION EXPERIENCE OF RESIDUAL GALLBLADDER AFTER CHOLECYCSTECTOMY

目的总结胆囊切除术后残余病变的诊断和再手术经验,避免再次发生胆囊残余病变。方法回顾性分析1990年1月～2009年12月间收治的34例胆囊残余病变的临床资料。结果本组术前均经B超、磁共振胰胆管造影(MRCP)、内镜逆行胰胆管造影(ERCP)检查明确诊断。34例全部再手术治愈,病理诊断均为残余胆囊慢性炎,3例合并异物肉芽肿形成,无癌变病例,无再次手术相关并发症。结论有症状的胆囊残余病变需要再次手术治疗,ERCP是诊断胆囊切除术后胆囊残余病变的最佳检查方法。

Objective To summarize the diagnosis and surgical reoperation experience of treating the residual gallbladder after cholecystectomy,Avoiding remaining gallbladder occurring again.Methods The clinical date of 34 cases with residual gallbladder after cholecystectomy between January 1990 and December 2009 were retrospectively reviewed.Results The 34 cases of residual gallbladder were made a definite diagnosis by B-ultrasonic,MRCP or ERCP before reoperation.Residual cholecystectomy was performed on all cases,and with choledochostomy on 11 cases,the pathological examination found there were chronic inflammatory changes in all of the specimens,foreign-body granuloma in 3 cases.There weren′t any cancerization or surgical complication in all cases.Conclusions It is suggested that residual gallbladder with severous symptom need to be reoperated.ERCP is the best methods in diagnosis of residual gallbladder.