成人胆总管囊肿的诊治

Diagnosis and treatment of adult congenital choledochalcyst

目的 进一步探讨成人胆总管囊肿的诊断和治疗。方法 回顾性分析 1985年 1月至1999年 1月手术治疗成人胆总管囊肿 42例资料 ,术后随访平均为 35个月 ,随访率为 80 %。结果 行囊肿十二指肠吻合术 2例 ,囊肿空肠 Roux- Y吻合术 10例 ,行囊肿切除加肝总管空肠 Roux- Y吻合术30例 ;术后胆瘘 2例 ,腹腔出血、胰瘘各 1例 ,无手术死亡。结论 囊肿切除加肝总管空肠 Roux- Y吻合术应为肝外胆管囊肿治疗的首选方法 ,局限性肝内胆管囊肿可行肝叶或半肝切除。

Objective In order to further discuss the diagnosis and treatment of adult congenital choledochal cysts.Methods To analysie 42 cases with congenital choledochalcysts from January 1985 to January 1999.The averagc time of following-up was 35 months.Results Two patients were operated with cystoduodenostomy,10 patients with Roux-en-y cystojejunsotomy,30 patients with resection of cyst with Roux-en-y hepaticojejunsotomy.Biliary fisfula happened in two patients,intraperitioneal hemorrhage in one patient,pancreatic fistula in one patient.No pafient was died during operation.Conclusions Resection of the cyst with Roux-en-y hepaticojejunostomy bring in fine effect.Hepatolobectomy is fit for the patients with local cystic lesion of the liver. [