先天性胆管扩张症132例临床研究  

Congenital billary dilatation:review of 132 cases

作　　者：张春燕[1] 杨云生[1] 孙刚[1] 李闻[1] 令狐恩强[1] 蔡逢春[1] 杜红[1] 孟江云[1] 王向东[1] 

机构地区：[1]解放军总医院消化科,北京100853

出　　处：《中国实用内科杂志》2009年第6期544-545,共2页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨先天性胆管扩张症的临床特点,了解胆总管扩张的分型及其并发症的发生。方法回顾性研究2001年1月至2008年8月在解放军总医院确诊的先天性胆管扩张的病例,分类采用Todani分类法。结果共收集先天性胆管扩张病例132例。其中80.3%属于Ⅰ型;Ⅱ型、Ⅲ型各占0.76%;Ⅳ型18%,Ⅳa型、Ⅳb型分别占全部病例的15.9%、1.5%;Ⅴ型占0.76%。Ⅳa及Ⅴ型为Caloli病,占16.7%。70%合并慢性胆囊炎;反复胆管炎占12.1%;胆道结石占41.7%;胆管狭窄占16.7%;胆汁性肝硬化占6.0%;癌变占10.6%;肾多发囊肿占3.8%。结论先天性胆管扩张症Ⅰ型最多见,Ⅱ、Ⅲ、Ⅴ型少见。常见并发症为慢性胆囊炎、胆管结石,约1/10患者发生癌变。Objective To evaluate the clinical features,the classification and complication of congenital billary dilatation （CBD）. Methods Retrospective study on the clinical data of 132 cases with CBD were made from January 2001 to August 2008 in Chinese PLA General Hospital. According to Todani＇ classification of congenital choledochal cyst to classify. Results 80.3% cases belonged to type Ⅰ ;0.76% totype Ⅱ and type Ⅲ;18% totype Ⅳ,15.9% totype Ⅳa,1.5% to type Ⅳb;0. 76% to types Ⅴ. 16. 7% to Caloli disease. 70% cases were chronic cholecystitis; 12. 1% cases were recurrent cholangeitis;41.7% cases were biliary calculi;16.7% cases were stricture of bile duct;6. 0% cases were biliary cirrhosis. 10. 6% cases were carcinoma;3.8% cases were renal polycyst. Conclusion Type Ⅰ is the most common in choledochal cyst. Type Ⅱ ,type Ⅲ and type Ⅴ were the less common. The most common Complication were chronic cholecystitisand biliary calculi. The frequency of malignant transformation was approximately 10%.

关 键 词：先天性胆总管扩张症 分型 并发症 

分 类 号：R5[医药卫生—内科学]