胆管囊肿的治疗现状及经验总结  

Current status and experience of treatment in choledochal cyst

作　　者：胡明泰 姜小清 HU Mingtai;JIANG Xiaoqing(Department of Hepatobiliary and Pancreatic Surgery,Dongfang Hospital Affiliated to Shanghai Tongji University,Shanghai 200120,P.R.China;DepartmentⅠof Biliary Tract Surgery,The Third Affiliated Hospital of Naval Medical University(Shanghai Eastern Hepatobiliary Surgery Hospital),Shanghai 200438,P.R.China)

机构地区：[1]上海市东方医院(同济大学附属东方医院)肝胆胰外科,上海200120 [2]海军军医大学第三附属医院(上海东方肝胆外科医院)胆道一科,上海200433

出　　处：《中国普外基础与临床杂志》2023年第1期18-22,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：上海市浦东新区科技发展基金事业单位民生科研专项(项目编号:PKJ2022-Y18);上海市浦东新区卫生系统学科带头人培养计划(项目编号:PWRd2022-05)。

摘　　要：胆管囊肿的特征是肝内和(或)肝外胆管单个或多个节段的囊状扩张,其临床症状不典型。当患者出现黄疸、腹痛、腹部肿块等症状时,应想到此病。胆管囊肿的分型复杂,Todani分型系统在临床中应用最为广泛。基于临床实践和思考,笔者团队在Todani分型系统的基础上建立了“三类五型”新的分型系统用于指导临床工作,该分型系统还需进一步验证。外科手术是治疗胆管囊肿的主要方式,手术方式取决于囊肿类型和胆管病变程度,治疗的原则包括完整切除囊肿并恢复胆肠的连续性。鉴于胆管囊肿术后仍存在较高的癌变风险,需对患者进行长期随访观察。Choledochal cysts are characterized by single or multiple cystic dilatations of the intrahepatic and/or extrahepatic biliary ducts.The typical presentation of this condition is non-specific.Clinicians must have a high clinical suspicion of choledochal cysts while investigating patients with jaundice,abdominal pain,and abdominal mass.There are multiple classifications for choledochal cysts.The Todani classification system is the most widely used in clinical practice.Based on clinical practice and thinking,we established a new“three regions and five types”classification system on the basis of Todani classification to guide clinical work,but further verification is needed.Surgery is the mainstay of treatment for choledochal cysts and the approach depends on the cyst type and the extent of hepatobiliary pathology.The principles of treatment include complete excision of the cyst and restoration of biliaryintestinal continuity.In view of the risk of biliary malignancy continues to be high after surgery,long-term follow-up is strongly recommended.

关 键 词：胆管囊肿 病因 分型 囊肿切除 预后 

分 类 号：R657.4[医药卫生—外科学]