胆总管囊肿穿孔的手术治疗

Treatment of perforated congenital choledochal cyst

目的 探讨先天性胆总管囊肿穿孔的诊断及治疗方法。方法 对 10例胆总管囊肿穿孔的临床资料进行回顾性分析。结果 男 6例 ,女 4例。平均年龄 4 5岁。病程 <12h者 4例 ,12～ 72h者 3例 ,>72h者 3例。 2例穿孔前合并感染 ,8例穿孔前无明显不适。 7例行一期囊肿切除、胆道重建术 ,5例术后恢复顺利 ,2例发生吻合口漏 ,其中 1例穿孔前合并感染 ,1例病程 >72h ;3例先行外引流 ,3个月后行囊肿切除、胆道重建术。结论 胆总管囊肿穿孔如为早期且治疗及时 ,可一期行囊肿切除、胆道重建术。

Objective To study the diagnosis and treatment of perforated congenital choledochal cyst(PTCC). Methods The clinical data of 10 children with PTCC were retrospectively analysed.Results 6 males, 4 females, average age 4.5 years old. The cyst perforted time within 12 hours was in 4 cases, 12～72 hours in 3, and more than 72 hours in 3. Of these cases, 2 had infection and the others had no obvious discomfort before perforation. Of 7 cases undergoing cyst excision and biliary reconstruction, 5 cases were recovered without complications; 2 occurred anastomostic leakaged(1 case had infection before perforation and the other with perforcted time more than 72 hours). 3 cases subjected to external drainage at first, and cyst excision and biliary reconstruction were performed on three months later. Conclusions If PTCC is treated earlier, cyst excision and biliary reconstruction can be performed as a primary operation.