胆囊十二指肠内瘘21例临床分析  

Clinical analysis to 21 cases of cholecystoduodenal fistula

作　　者：邓科平 龚双喜 周厚吾 

机构地区：[1]长沙市第一医院普外科,410005

出　　处：《腹部外科》2013年第2期107-108,共2页Journal of Abdominal Surgery

摘　　要：目的总结胆囊十二指肠内瘘的诊治经验。方法分析2005年1月至2011年12月收治的21例胆囊十二指肠内瘘的临床资料。结果慢性结石性胆囊炎是引起胆囊十二指肠内瘘的主要原因。术前通过逆行胰胆管造影（ERCP）诊断3例，磁共振胰胆管成像（MRCP）、胃镜、上消化道造影疑是诊断12例，其余的均为术中明确诊断。其中开腹手术15例，腹腔镜手术1例，腹腔镜中转开腹手术5例，21例患者均治愈。结论胆囊十二指肠内瘘术前诊断困难，术中探查对胆囊十二指肠内瘘的诊断起重要作用。选择合适的手术方式和术后营养支持对于防止肠瘘和其他并发症十分重要。Objective To summarize the experiences in diagnosis and treatment of cholecytoduodenal fistula. Methods FrOm January 2005 to December 2011, totally 21 patients with cholecytoduo- denal fistula underwent treatment in out center and their clinical data were analyzed. Results Chronic was the key cause to cholecytoduodenal fistula. The diagnostic approaches included 3 cases by ERCP, 12 cases by MRCP, gastroscopy and upper-gastrointestinal tract examination before operation, The remains was confirmed by intraoperative observation. 15 cases underwent open operation, and 6 cases underwent laparoscopic surgery, in which 5 cases were converted to open procedure. All patients recovered smoothly. Conclusion Accurate diagnosis is difficult for cholecytoduodenal fistula in pre-operative period, and intraoperative diagnosis is an important supplement. Selection of proper surgical management and nutritional support in pos-toperation are very important to occurrence of intestine fis- tula and other complications, including cholecytoduodenal fistula.

关 键 词：胆囊炎 胆瘘 肠瘘 

分 类 号：R657.4[医药卫生—外科学]