22例先天性胆总管囊肿初次手术方式与远期并发症

The relationship between pattern of surgery at the first time for congenial common bile duct cyst patients and the incidence of long-term complication

目的 探讨合理选择先天性胆总管囊肿的初次手术方式 ,以期提高疗效 ,降低远期并发症。方法 对 1 980～ 2 0 0 2年在本院经治的 2 2例先天性胆总管囊肿病人初次手术方式与并发症的临床资料进行回顾性分析。结果 单纯内引流术 (囊肿十二指肠或空肠吻合术 ) 1 0例 ,术后有 6例反复逆行胆道感染 ,2例同时伴发慢性胰腺炎 ,囊肿癌变 1例。其远期并发症发生率高达70 % (7/ 1 0 )。囊肿切除、肝总管空肠Roux Y吻合术或加用同步吻合术共 1 2例。术后仅 1例发生胆管炎 ,并发症率 8 3% (1 /1 2 )。结论 合理选择初次手术方式 ,条件允许时 ,对先天性胆总管囊肿力求选择囊肿切除 ,肝总管空肠Roux

Objective To study the surgery pattern at the first time of congenital common bile duct cystis for improving the effect of therapy and decreasing the incidence of long term complication.Methods Retrospective analysis of relationship between surgery pattern at the first time and the long term complication on 22 patients of congenital common bile duct cystis from 1980 to 2002.Results Ten patients applied internal drainage purely(cyst duodenum or jejunum anastomosis),which 6 patients retrograded bile duct inflammtion repeatedly after surgery,two patients concomited chronic pancreatitis and 1 patient had carcinomatous change of cyst.The incidence of long term complication was about 70%.12 patients applied combined cyst resection and common hepatic duct and jejunum Roux Y anastomosis or synchronous anastomosis,which only one patient occurred cholangitis.The incidence of long term complication was about 8.3%.Conclusion For congenital common bile duct cyst patients,the pattern of surgery of cyst resection programmed common hepatic duct jejunum Roux Y anastomosis and synchronous anastomosis at the first time may decrease obviously incidence of long term complication.