胆囊管综合征的诊断与治疗

Diagnosis and treatment of cystic duct syndrome

目的:探讨胆囊管综合征(cystic duct syndrome,CDS)的诊断方法及治疗措施。方法:回顾分析36例CDS的临床症状、诊断流程及治疗结果。结果:36例CDS均具有典型的胆绞痛症状。术前常规进行腹部超声、口服胆囊造影等检查,21例行MRCP检查提示胆囊管迂曲、慢性胆囊炎或胆囊积液。12例病程中发现继发性胆囊结石。合并急性化脓性胆囊炎6例。31例顺利实施腹腔镜胆囊切除术,其中2例行经脐单孔腹腔镜胆囊切除术。5例实施开腹胆囊切除术。术中所见及术后病理学检查均支持CDS的诊断。结论:CDS的诊断需综合考虑临床症状、影像学检查、术中发现及术后病理学检查等因素,腹腔镜胆囊切除术是CDS的理想治疗方法。

Objective：To discuss the diagnostic method and therapeutic measure of cystic duct syndrome（CDS）.Methods：The clinical symptoms,diagnosis process and treatment outcome were analyzed retrospectively in 36 patients with CDS.Results：All of the 36 patients had the typical abdominal symptoms containing biliary colic.Abdominal ultrasound and oral cholecystography were routinely performed in 36 patients,and magnetic resonance cholangiopancreatography（MRCP） indicated cystic duct circuity,chronic cholecystitis and hydrops of gallbladder in 21 patients.The secondary gallbladder stones were found in 12 patients.Six patients were complicated with acute suppurative cholecystitis.Laparoscopic cholecystectomy（LC） was performed successfully in 31 patients,and 2 patients of them received transumbilical single-port laparoscopic cholecystectomy（TUSPLC）.Five patients underwent conventional open cholecystectomy.The intraoperative findings and postoperative pathological examination were consistent with the diagnosis of CDS.Conclusion：The diagnosis of CDS should be based on clinical symptoms,medical imaging,intraoperative exploration and postoperative pathological results.LC may be an ideal treat method for CDS patients.