胆总管囊肿再次手术11例分析  

ANALYSIS OF 11 CHOLEDOCHOCYST RE-OPERATION

作　　者：胡志坚[1] 柴新群[1] 柏立山[1] 叶伦[1] 冯贤松[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院肝胆外科,武汉430022

出　　处：《肝胆外科杂志》2011年第3期174-176,共3页Journal of Hepatobiliary Surgery

摘　　要：目的分析胆总管囊肿再次手术的原因,试图减少再次胆道手术次数。方法 2005年3月～2009年3月,我院收治胆总管囊肿再次手术11例,对其临床资料进行回顾性分析。结果 11例胆总管囊肿再次手术患者,Ⅰ型9例,Ⅳa型1例,Ⅳb型1例;既往一次手术史者9例,两次手术史者2例;就诊时症状,右上腹痛8例,发热4例,黄疸2例;就诊原因,胆总管结石并胆管炎5例,胆总管下端良性狭窄3例,残余胆囊1例,胆瘘1例,单纯性胆管炎1例。11例患者均行胆肠吻合术后痊愈出院,无死亡病例,随访中无明显并发症。结论胆总管囊肿再次手术的主要原因是误诊、漏诊和手术方式选择错误;胆总管囊肿的治疗以胆总管囊肿切除胆总管空肠Roux-en-Y吻合术为佳。Objective To reduce the bile duct re-operation by analyzing the choledochocyst re-operative cases.Methods Retrospectively analyse all the clinical data of the 11 choledochocyst re-operative cases from March 2005 to March 2009 in our hospital.Results Of the 11 choledochocyst patients,9 cases belonged to typeⅠ,1 belonged to type Ⅳa,1 belonged to Ⅳb;9 patients had experienced 1 operation,2 had experienced 2 operations;of all the patients,8 patients had the symptom of abdominal pain,4 got fever,2 got jaundice;5 patients got biliary calculus accompany with cholangitis,3 got benign stricture of subterminal common bile duct,1 had remnant cholecyst,1 got biliaryfistula,1 got simple cholangitis.All the 11 patients were cured without complications and death.Conclusions The main cause of choledochocyst re-operation is misdiagnosis and missed diagnosis of choledochocyst;the classic symptoms of choledochocyst are rare among adult patients,the best treatment of choledochocyst is Roux-en-Y choledochojejunostomy.

关 键 词：胆总管囊肿 个体化 再次手术 胆总管空肠吻合术 

分 类 号：R657.44[医药卫生—外科学]