小儿先天性胆总管囊肿的手术治疗要点

A Retrospective Analysis of Surgery Treatment for Pedo-congenital Choledochus Cyst

目的探讨小儿先天性胆总管囊肿的手术治疗要点。方法回顾性分析2001年1月至2013年2月我院收治的28例先天性胆总管囊肿患儿的，临床资料，患者均采用胆总管囊肿切除＋肝总管空肠Roux-吻合术，观察患者病理检查结果、手术时间、术中出血量、手术并发症等指标。结果38例患者手术时间120～200min。手术出血量10～80mL均痊愈出院，平均住院时间18d。随访6个月～12年，全组患者未再次手术，MRCP复查提示胆肠吻合口通畅，肝内外胆管无狭窄、无扩张、无结石。结论胆总管囊肿切除＋肝总管空肠Roux-Y吻合术是治疗先天性胆总管囊肿的理想方法。

Objective To investigate main points of operation for pedo-congenital common duct cyst. Methods 28 in-patients with congenital choledochus cyst in our hospital （from 2001.01 to 2013.02） were retrospectively analyzed. All these 28 patients underwent choledochocystectomy and Roux-Y anastomosis of common hepatic duct-jejunum; pathological result~ operation duration, hemorrhage volume of intraoperation and complications of the cases were taken into count. Result In the 28 cases, the duration range from 120 to 200 minutes, the hemorrhage range from 10-80 mL and the average stay were 18 days, all of them were discharged from hospital with recovery. Within the follow-up of 6 months to 12 years, all the 28 patients were free of reoperation, and the magnetic resonance cholangiopancreatography （MRCP） review showed that all chol-intestinal anastomosises are unobstructed, the exterior and interior bile ducts are free of stenosis, ectasia and calculus. Conclusion Choledochocystectomy plus Roux-Y anastomosis of common hepatic duct- jejunum is an ideal treatment for pedo-congenital common duct cyst.