成人胆囊管囊肿25例临床分析  

Clinical analysis of cystic dilatation of the gallbladder cystic duct in 25 adults

作　　者：杨维良[1] 李胜龙[1] 张好刚[1] 张东伟[1] 张浩民[2] 赵志 

机构地区：[1]哈尔滨医科大学附属第二医院普外科,150086 [2]齐齐哈尔医学院附属第二医院普外科 [3]牡丹江市第二医院普外科

出　　处：《中华普通外科杂志》2014年第7期507-509,共3页Chinese Journal of General Surgery

摘　　要：目的 探讨成人胆囊管囊肿的诊断及治疗.方法 回顾性分析1991-2012年收治的经手术证实的成人胆囊管囊肿25例的临床资料.结果 本组25例患者均有慢性胆囊炎表现,其中14例右上腹反复发作性胆绞痛病史及恶心、呕吐等消化道症状;9例巩膜、皮肤黄染,并畏寒、高热.经彩超检查25例、ERCP 16例及MRCP 9例检查,均于胆囊管处显示直径1.6 cm×1.6 cm～2.5 cm ×2.5 cm液性暗区,23例其内有强光点,并同时存在胆囊扩张影,即所谓特征性类似“哑铃形”影像,其中23例B超检查发现胆囊内显示强光点.术前诊断：胆囊管囊肿伴结石或胆囊结石.术中所见基本同术前诊断一致.25例行胆囊和胆囊管囊肿联合切除术.术中2例损伤胆管并同时行肝管空肠Roux-en-Y吻合术.25例均痊愈.结论 胆囊管囊肿是胆管囊肿分型的第Ⅵ型,临床上罕见,手术治疗效果优良.Objective To explore the diagnosis and treatment of cystic dilatation of the cystic duct in adults.Method Clinical data of 25 cases of the cystic dilatation of cystic duct in adults in 3 hospitals in Songhuajiang river drainage area from 1991 to 2012 confirmed by surgery were analyzed retrospectively.Results The 25 cases were with manifestations of chronic cholecystitis,and 14 patients with right upper quadrant recurrent biliary colic and nausea,vomiting and other gastrointestinal symptoms,9 patients with yellowish discoloration of sclera and skin,and fever.Ultrasonography was done in 25 cases,ERCP in 16 cases and MRCP in 9 cases,displaying liquid dark area of diameter from 1.6 cm × 1.6 cm to 2.5 cm ×2.5 cm in the gallbladder tube suspective of calculi,and characteristic dumbbell shape image.Preoperative diagnosis was cystic duct cyst with stones or gallstones which was confirmed by surgery.Gallbladder and cyst resection was performed in all 25 cases,and bile duct jejunum Roux-en-Y anastomosis was done in 2 of these cases because of introgenic bile duct injury.Conclusions Cysts of the cystic duct is the special type （Ⅵ type） of choledochocele,and its prognosis is good after surgical treatment.

关 键 词：胆囊结石病 胆总管囊肿 

分 类 号：R657.4[医药卫生—外科学]