紧贴囊壁剥离法切除胆总管囊肿的临床评价

Evaluation of cyst excision nestling up against the cyst wall dissecting for choledochal cysts

目的 对紧贴囊壁剥离法 (或称疝囊剥离法 )切除胆总管囊肿的安全性及可行性进行评估。方法 回顾 1984～ 1999年的胆总管囊肿 113例 ,其中 10 6例行囊肿切除、胆肠Roux en Y吻合术 ,均是采用敞开囊腔紧贴囊壁剥离法切除囊肿。结果 10 6例手术均顺利 ,无意外损伤 ,失血量、输血量绝大多数在 2 0 0ml以内 ,3例未输血 ,无严重并发症及死亡。结论 敞开囊腔紧贴囊壁剥离法简化了手术操作和降低了手术难度 ,增加了手术安全性 ,因而被认为是切除胆总管囊肿的安全、有效。

Objective To evaluate the reliability and feasibility of cyst excision nestling up against the cyst wall for choledochal cysts.Methods 113 cases of choledochal cysts from 1984 to 1999 were retrospectively studied. 106 cases received cyst excision with Roux-en-Y hepaticojejunostomy. The cyst excision in all cases was performed by nestling up against the cyst wall to dissect and resect the cyst.Results The operations were performed successfully on all 106 cases without unexpected operative injury. The amount of hemorrhage and blood transfusion were less than 200 ml. 3 cases did not receive blood transfusion. No serious complications or deaths occurred. Conclusions The method of cyst excision nestling up against the cyst wall dissecting for choledochal cysts is safe ,effective and simple. It can facilitate the operation and improve the safety.