先天性胆管囊肿术后再次手术分析

Reoperation of congenital choledochal cyst

目的探讨先天性胆管囊肿再次手术的原因和外科处理要点。方法回顾分析6年间我院收治的先天性胆管囊肿术后再次手术病例(35例)的临床资料。结果再次手术的原因主要有:胆肠吻合口狭窄伴肝内胆管结石、残余胰腺段胆管囊肿伴结石、胆管囊肿癌变。再次手术的方式以胆管囊肿彻底切除、肝门部胆管整形、胆道探查取石、肝总管空肠Roux-en-Y吻合术、及胰十二指肠切除术为主要术式。结论先天性胆管囊肿手术后再次手术的关键包括残余囊肿切除、消除胆胰管合流异常、解除吻合口梗阻、通畅胆汁引流、去除肝内肝外结石病灶等。

Objective To analyze the causes of and principles for reoperation of congenital choledochal cyst （CCC）. Methods Review congenital biliary duct cyst postoperative analysis of 6 years hospital reoperation cases （ 35 cases）. Result The main reasons of reoperation ：Bilioenteric anastomotic stenosis complicated with intrahepatic bile duct stones＇; Remaining pancreatic gland section bile duct cyst with stones ; Cyst of bile ductcanceration. The mainly reoperation way is complete removal of bile duct cysts,bile duct exploration stone hepatic duct jejunum roux-en-y anastomosis, and pancreaticoduodenectomy. Conclusion Critical congenital bile duct cysts after surgery, reoperation including the the residual cyst removal, elimination of bile pancreatic duct confluence abnormality, remove anastomotic obstruction, biliary drainage, removal of intrahepatic, extrahepatic stove and so on.