先天性胆总管囊肿切除阑尾间置胆道重建远期随访观察  

LONG-TERM RESULTS FOR INTERPOSITION OF PEDICLED APPENDIX AFTER CHOLEDOCHOCYSTECTOMY

作　　者：魏明发[1] 李俊[1] 杨小进[1] 周学锋[1] 张鹏[1] 袁继炎[1] 王果[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《肝胆外科杂志》2001年第4期254-256,共3页Journal of Hepatobiliary Surgery

摘　　要：目的　观察先天性胆总管囊肿的囊肿切除后阑尾间置重建胆道的远期效果。方法　对患儿的临床表现、必要的生化检查、B型超声、钡餐以及 SPECT的结果进行手术前后及远期对比综合分析评价。结果　 13例中发育营养佳 ,肝功能正常 ,无任何症状者 12例 ,占 92 .3 % ,仅 1例虽发育营养佳 ,但偶有能自行缓解的上腹剑突下疼痛 ,所有的 B型超声检查无肝内胆管扩张和积气 ,SPECT检查间置胆道显影清晰、流经通畅、肠道显影 ,GI检查无返流。结论　先天性胆总管囊肿切除阑尾间置重建胆道 10年随访效果好 ,只要手术中阑尾无病变 ,其系膜和动脉血管转移至肝门处无张力 ,阑尾间置重建胆道是一种可推荐的手术方法。Objective To study the long-term results of vascularized appendiceal transplants in biliary tract after choledochal cyst excision.Methods The pre-and-postoperative clinical manifestation,biochemistry examination,B-ultrasonography(B-US),upper gastrointestinal(GI) X-ray series and single proton ejected computerized tomography(SPECT) scanning of children with choledochal cyst were contrasted and evaluated comprehensively.Results 13 cases were followed up for a period of 4～10 years,12 of them are growing and developing well without any symtoms(92.3%),one had only abdominal pain.All the dilated intrahepatic bile ducts had become normal presented by postoperative B-US.Biliary ducts were reconstructed fluently and manifested clearly on SPECT,and no one had reflux on GI examination.Conclusion We find it is advantegeous to reconstruct biliary ducts using pedicled appendix as a kind of interposition material.We recommend it is an important way for the treatment of choledochal cyst except the appendix is diseased or the length of the vascular pedicle is inadequate.

关 键 词：胆总管囊肿 胆管-阑尾-十二指肠吻合术 治疗 

分 类 号：R657.44[医药卫生—外科学]