胆囊十二指肠内瘘14例诊治体会  

Diagnosis and treatment of complicated chronic cholecystitis with cholecyst-duodenal fistula

作　　者：卫庆文 汪校 胡锟 

机构地区：[1]湖北省鄂州市第二医院普外科,436000

出　　处：《腹部外科》2006年第1期45-46,共2页Journal of Abdominal Surgery

摘　　要：目的探讨慢性胆囊炎、胆囊十二指肠内瘘的诊断及治疗原则。方法对9年间收治的14例慢性胆囊炎并十二指肠内瘘病人的临床资料进行回顾性分析,从临床表现、诊断、手术方法方面加以总结。结果行胆囊切除+十二指肠瘘口修补术6例,胆囊切除+十二指肠瘘口修补+胃大部切除毕Ⅱ式吻合术3例,胆囊大部切除经胆囊十二指肠瘘口引流术5例。全部病例均-期手术痊愈出院。结论本病缺乏特异性的临床表现,术前诊断困难,术前B型超声及十二指肠肠镜检查是主要辅助诊断手段,手术治疗是唯一有效的治疗方法。Objective To explore the diagnosis cholecystitis with cholecyst-duodenal fistula. Methods and treatment principle of complicated chronic The clinical findings, diagnosis and operative modes of 14 patients with complicated chronic cholecystitis with cholecyst-duodenal fistula in our hospital in recent 9 years were analyzed retrospectively. Results The preoperative correct diagnosis rate by B-Ultrasound or biopsy was 21.4 % or 75 % respectively. Cholecysteetomy with repairing fistula was performed on 6 cases, cholecystectomy with repairing fistula and subtotal gastrectomy on 3 cases, and 5 cases underwent residual eholeeysteetomy and choleeyst-duodenal fistula drainage. All 14 cases were one-stage cured. Conclusion The disease was short of classical clinical symptom, so its diagnosis is difficult. B-Ultrasound and biopsy are the primary means of diagnosis. Operation is the only effective treatment.

关 键 词：胆囊炎 十二指肠疾病 消化系统瘘 胆囊十二指肠内瘘 诊治体会 瘘口修补术 慢性胆囊炎 毕Ⅱ式吻合术 胆囊大部切除 诊断困难 

分 类 号：R657.4[医药卫生—外科学] R656[医药卫生—临床医学]