先天性胆总管囊肿54例诊治体会

UNDERSTANDING OF DIAGNOSIS AND TREATMENT FOR 54 CASES OF CONGENITAL CHOLEDOCHOCYST

目的 提高对先天性胆总管囊肿的诊断和治疗水平。方法 回顾性总结分析沂蒙山区４所市直医院２４ 年间收治的先天性胆管囊肿５４ 例。结果 经 Ｂ 超检查的确诊率为９６ ．３ ％ ， Ｃ Ｔ 检查的确诊率为１００ ％ 。５４ 例均经手术治疗，其中囊肿十二指肠吻合２ 例中１ 例再次手术；囊肿部分切除、囊肿空肠 Ｒｏｕｘ － ｅｎ － Ｙ 吻合８ 例中再次手术１ 例；４４ 例囊肿切除、肝总管空肠 Ｒｏｕｘ － ｅｎ － Ｙ 吻合（ 综合性方法） 术后均无临床不适，无逆行感染。结论 对怀疑先天性胆总管囊肿病人，应行 Ｂ超、 Ｃ Ｔ 等检查。一旦确诊，应及早手术，并做好围手术期处理，手术以囊肿切除、肝总管空肠 Ｒｏｕｘ －ｅｎ － Ｙ（ 综合性方法） 吻合为好。

Objective To improve the diagnostic and therapeutic levels of congenital choledochocyst.Methods A retrospective summary analysis was made on 54 cases of congenital choledochocyst received and treated in 4 municipal affiliated hospitals in 24 years.Results The rates of confirmed diagnosis by B-ultrasonic scanning and by CT examination were 96.3% and 100% respectively.All the 54 cases were treated surgically,among which 2 cases received cystoduodenostomy with one case undergoing secondary operation,8 cases received partial cystectomy and Roux-en-Y cystojejunostomy with one case undergoing secondary operation, and 44 cases received cystectomy and Roux-en-Y choledochojejunostomy (combined treatment ), without any postopetrative clinical indispositions and retrograde infection.Conclusion Clinically, as long as the patients are suspected of suffering from congenital choledochocyst,such examinations as B-ultrasonic and CT scanning examinations should be performed.Once the diagnosis confirmed,the operation should be carried out earlier and disposal around the operative time must be done well.Cystectomy and Roux-en-Y choledochojejunostomy (combined method ) should be taken as the best operative methods.