成人胆总管囊肿手术治疗76例临床分析  

Surgical treatment for adult congenital choledochal cysts:an analysis of 76 cases

作　　者：龚军[1] 俞小炯[1] 温尔刚[1] 董科[1] 

机构地区：[1]四川省医学科学院(四川省人民医院)肝胆胰外科,四川成都610072

出　　处：《中国现代医学杂志》2013年第34期67-69,共3页China Journal of Modern Medicine

摘　　要：目的总结成人胆总管囊肿的诊断及治疗体会。方法回顾性分析该院2004年1月~2012年1月76例成人先天性胆总管囊肿患者临床资料。结果 76例患者均接受手术治疗,其中术式包括：①囊肿完整切除、肝总管空肠端侧吻合72例;②4例癌变患者,2例行胰十二指肠切除术（囊肿下份癌变）,2例行胆管癌根治术。76例手术患者中获随访72例,随访6个月~6年,平均36个月,良性患者情况良好。癌变患者中,2例行胆管癌根治术患者失访,术后胆瘘1例,经保守治疗痊愈,无手术死亡。结论胆总管囊肿一旦诊断应尽早手术治疗。囊肿切除加肝总管空肠Roux-en-Y吻合术为胆管囊肿治疗的首选方法,可避免术后逆行感染和癌变可能,是治疗胆总管囊肿的首选手术方式。[Objective] To investigate diagnosis, treatment of adult congenital choledochal cysts. [Methods] Be- tween January 2004 and January 2012, there were 76 cases of adult congenital choledochal cysts, the clinical datawere analyzed retrospectively. [Result] All patients underwent operation, surgical procedures including： （1） 72 cases had total cyst excision and hepatic duct jejunum end to side anastomosis. （2） Among 4 cases with cancer, 2 cases underwent pancreaticoduodenectomy （Cyst under parts of cancerous）, 2 cases underwent cholangiocarcinoma radical mastectomy, Among the 76 cases, 72 patients were followed- up, Follow- up period was 6 months to 6 years, mean 36 months,patients with benign disease were in excellent conditions. Among malignant disease patients, 2 cas- es of cholangiocarcinoma radical mastectomy patients lost follow-up, 1 case biliary fistula, cured by conservative treatment, this group was no operative mortality. [ Conclusion ] Once the diagnosis of choledochal cyst surgical treatment as soon as possible, cyst resection and hepatic duct jejunum Roux-en-Y anastomosis was preferred method for treatment the choledochal cyst, It can avoid postoperative retrograde infection and malignant, which is the preferred surgical method for the treatment of choledochal cyst.

关 键 词：胆总管囊肿 手术治疗 成年人 

分 类 号：R575.7[医药卫生—消化系统]