外科治疗合并华支睾吸虫感染的胆道疾病125例

Surgical treatment for biliary tract diseases with clonorchiasis in 125 patients

目的 探讨外科治疗合并华枝睾吸虫感染的胆道疾病特点。方法 回顾 1997年 1月至 2 0 0 1年 12月手术或内镜治疗的合并华枝睾吸虫感染的胆道疾病 12 5例 ,良性病变 10 7例(85 .6 % ) ,恶性病变 18例 (14 .4 % ) ,合并重症胆管炎 (ACST) 2 1例 (16 .8% ) ,合并梗阻性黄疸 6 3例 (5 0 .4 % ) ,急诊手术 4 2例 (33.6 % )。手术方式以胆囊切除、胆总管探查和内镜下十二指肠乳头括约肌切开术 (EST)为主。结果 良性病变中 1例死于术后ACST ,5例结石复发 2次手术。恶性病变中围手术期死亡 3例 ,生存期 3个月至 2年。结论 不仅华支睾吸虫本身可引起胆道外科疾病 ,而且引起一系列合并症 。

Objective To evaluate the effectiveness of surgical treatment for the biliary tract diseases with chonorchiasis. Methods 125 cases between Jan. 1997 and Dec. 2001 were reviewed retrospectively. 107 cases (85.6%) had benign diseases, 18 (14.4%) malignant diseases, 21 (16.8%) coexistent acute cholangitis severe type (ACST), 63 (50.4%) concomitant obstructive jaundice. 42 cases (33.6%) underwent emergency operation. The main operative procedures were cholecystectomy, exploration of common bile duct and endoscopic sphincterotomy (EST). Results 1 case with benign diseases died of postoperative ACST, 5 cases were reoperated on because of lithiasis recurrence. 3 cases with malignant diseases died during the perioperative period. The survival time ranged from 2 months to 2 years. Conclusions Clonorchiasis sinensis can not only cause biliary tract diseases, but also induce a series of complications. Surgical proceduce and treatment for clonorchiasis sinensis should be emphasized as well.