中央型胆管囊肿的手术难点和处理策略  

Surgical difficulties and management strategies for central choledochal cysts

作　　者：李斌 邱智泉 张吉祥 姜小清 LI Bin;QIU Zhiquan;ZHANG Jixiang;JIANG Xiaoqing(DepartmentⅠof Biliary Tract Surgery,Eastern Hepatobiliary Surgery Hospital&Biliary Tract Malignancy Treatment Centre,Secondary Military Medical University,Shanghai 200438,P.R.China)

机构地区：[1]海军军医大学东方肝胆外科医院胆道一科、海军军医大学胆道恶性肿瘤诊疗中心,上海200438

出　　处：《中国普外基础与临床杂志》2023年第1期7-11,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：上海市科委科技支撑-西医引导类项目(项目编号:19411967000);孟超人才计划项目(项目编号:中青年英才-2019)。

摘　　要：外科手术能够实现切除胆管囊肿病灶、彻底缓解胆管炎症、阻断囊肿发生癌变等治疗目标,是治疗先天性胆管囊肿唯一有效的手段。中央型胆管囊肿的手术要点涉及囊肿切除、胆肠吻合、胆-胰分流等多个核心环节,其手术难点在于对肝门和胰腺区域的胆管囊肿的合理决策和有效处理。根据不同解剖形态的中央型胆管囊肿类型,建立合理可行的个体化的手术处理策略,能够有效规避术后发生胆汁漏、胆肠吻合口狭窄、残余胆管囊肿、癌变等不良的治疗后果。Surgery is the only effective treatment for congenital choledochal cysts,as it allows for the resection of the cysts,the complete relief of cholangitis,and the prevention of canceration of cysts.The key elements of surgery for central choledochal cysts involve the cysts resection,bile-intestinal anastomosis,and biliopancreatic diversion.The difficulty in operating on central choledochal cysts lies in the rational decision making and effective management of cysts in the hilar and pancreatic regions.Depending on the type of central choledochal cysts with different anatomical patterns,a reasonable and feasible individualized surgical management strategy can be established to effectively avoid adverse therapeutic consequences such as postoperative biliary leakage,cholangio-intestinal anastomotic stricture,residual choledochal cysts and its carcinogenesis.

关 键 词：中央型胆管囊肿 手术策略 并发症 计划性肝切除 

分 类 号：R657.4[医药卫生—外科学]