小儿先天性胆管扩张症97例诊治体会

Diagnosis and treatment of congenital cholangiectasis in children:report of 97 cases

目的总结小儿先天性胆管扩张症的诊治经验。方法回顾性分析我院2001年3月至2010年3月收治的97例先天性胆管扩张症的诊治资料。结果 94例以腹痛、黄疸及腹部肿块等临床症状结合B超、CT、MRCP等检查而确诊,3例急腹症患者术中确诊。4例行二期手术,均行囊肿切除、肝管空肠Roux-en-Y吻合术而痊愈。结论 B超、CT和MRCP等检查是诊断先天性胆管扩张症的主要方法,囊肿彻底切除、肝管空肠Roux-en-Y吻合术是标准的手术方式,微创手术材料与微创理念是保证手术疗效的关键。

Objective To summarize our experience in the diagnosis and treatment of congenital cholangiectasis.Methods 97 patients with congenital cholangiectasis admitted from march 2001 to march 2010 were reviewed.Results Associating the clinical symptom of abdominal pain,jaundice and abdominal mass with B-ultrasound,computer tomography（CT） and MRCP examination,94 cases were made definite diagnosis.3 acute cases were made diagnosis in operation.All patients were cured though the operative method of cyst excision with Roux-en-Y hepaticoje-junostomy.Conclusion B-ultrasound,CT and MRCP are effective to diagnose congenital cholangiectasis,and also are helpful to guide its operation.Cyst excision entirely and Roux-en-Y hepaticojejunostomy is a standard surgical method to treat this disease.Micro-invasive stuff and micro-invasive idea are important to operating effect.