胆总管囊肿对肝脏和胰腺的影响

The impact of choledochal cyst on the liver and the pancreas

目的观察胆总管囊肿对肝脏胰腺的影响及术后恢复情况。方法对１９８８～１９９８年收治的６１例胆总管囊肿进行血丙氨酸转氨酶、尿淀粉酶、Ｂ型超声等检查，并对有关资料做回顾性分析。结果术前血丙氨酸转氨酶升高３３例（５４％），术后１周恢复正常２１例。术前检查尿淀粉酶３７例，升高１９例，术后恢复正常１１例。Ｂ型超声显示肝肿大和肝回声改变２６例，胰腺病变１１例。术中发现明显胆汁淤积肝肿大或肝硬变６例，慢性胰腺炎３例。结论胆总管囊肿易引起肝脏胰腺损伤，但常为可逆性，宜早期手术，长期则可导致慢性不可逆病变。

Objective To investigate the impact of choledochal cyst on the liver and pancreas and the reversibility after surgery.Methods During a period between 1988 and 1998,61 children suffering from choledochal cyst were admitted.The perioperative clinical data were analysed retrospectively including serum glutamic pyruvic transaminase (GPT),urine amylase,echography.Results Thirty three cases had a preoperative elevation of SGPT,21 of them recovered in the first week after operation.In 37 cases who had preoperative urine amylase test,19 had a elevation and 11 recovered postoperatively.twenty six had preoperative hepatmegaly and echoic change of liver,and 11 cases had pancreatic lesion revealed by echography.Laparotomy found obvious cholestasis hepatomegaly and hepatocirrhosis in 6 cases,and 3 of chronic pancreatitis were found.Conclusions Reversible malfunction and gross abnormality of the liver and pancreas is common in patients with choledochal cyst,and chronic and irreversible lesion of the liver and pancreas could ensue when the primary disease leaves untreated.