胆管囊肿的诊断与治疗体会

Diagnosis and treatment of choledochocyst

目的:总结胆管囊肿的诊断和治疗经验.方法:回顾分析我院1983年3月~001年2月间收治36例胆管囊肿,对其病因、分型、临床表现、诊断及手术治疗进行分析.结果:腹痛24例(66.7%),腹部包块15例(41.7%),黄疸21例(58.3%),三联征同时存在14例(38.9%),32例B超可显示胆管囊肿形态和大小、是否合并肝内胆管扩张及结石等,诊断符合率93.6%;囊肿-空肠-Y式吻合术12例,术后均反复胆系感染,1例癌变;囊肿切除、肝管-空肠Roux-en-Y14例;囊肿切除、短段空肠代胆道10例(人工乳头),经术后随访1年～3年,效果良好.结论:腹痛、腹部包块、黄疸为主要临床表现,B超检查无损伤,价格廉,准确率高,应为首选检查方法.囊肿切除短段空肠代胆道术符合生理,疗效满意,应为胆管囊肿主要术式.

ve To study the diagnosis and treatment of choledochocyst. Method Retrospective 36 cases of choledocholcyst from March 1983 to February 2001, The infections path, classification, clinical characteristic, diagnosis and treatment are discussed. Results Abdominal pain(66.75,24 cases), abdominal mass(41.75, 15 cases), jaundice(58.3, 21 case), all of three(38.9%, 14 cases), the diagnosis of 32 cases is mainly depent on Bultrasonography, 93.6 % of the patient got correct diagnosis before operation. Choledo-choduodenostomy' Y operation was used in 12 case, they are all morbidity of biliary infection after operation. Cancaeration of lease, resec-tion of choledochoeyst, intrahepat cholangio jejunostomy Roux-en-Y in 14 cases; esection of choledochoeyst, jejunum-interpositioned in 10 case(with a antireflux valve) . The general conditionis well during the follow up of 1-3 years after operation. Conclusion Abdominal pain, abdominal mass, jaundice is main clinical characteristic, Bultrosnography isn't harm, cost is cheap, It is main means to diagnose the choledochocyst, Resection of choledochocyst and jejunum-interpositioned is a major operation.