肝细粒棘球蚴病胆道并发症的研究进展  

Research progress of biliary complications of hepatic cystic echinococcosis

作　　者：祖米来提·波拉提 胡雪源 郭强 蒋铁民[1,2] Zumilaiti Bolati;Hu Xueyuan;Guo Qiang;Jiang Tiemin(Department of Hepatobiliary&Hydatid Disease,Digestive&Vascular Surgery Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;State Key Laboratory of Pathogenesis,Prevention and Management of High Incidence Diseases in Central Asia,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院消化血管外科中心肝胆包虫病外科,乌鲁木齐830054 [2]新疆医科大学省部共建中亚高发病成因与防治国家重点实验室,乌鲁木齐830054

出　　处：《中华普通外科学文献(电子版)》2025年第2期119-123,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题基金项目(SKL-HIDCA-2024-22);中央引导地方科技发展专项资金项目(ZYYD2022B06)。

摘　　要：肝细粒棘球蚴病(HCE)破入胆道引起的胆道并发症是最为常见且严重的并发症之一,主要通过其临床表现结合影像学检查来明确诊断。外科手术是HCE破入胆道最有效的治疗方法,需要在根治性手术或保守手术的基础上合理实现胆道减压、清除胆道内囊性物质,保持胆道通畅。合理处理术后并发症时,胆总管探查T管引流术较为常用,并在瘘管和胆道内放置双T管减压引流,内镜逆行胰胆管造影术(ERCP)作为HCE破入胆道的一种术前及术后重要技术,可有效清除破入胆道的内容物,解除胆道梗阻,进一步降低感染风险。本文从HCE胆道并发症的临床表现、诊断、治疗等方面进行综述,以期通过早期发现、诊断并处理影响其发生的因素,从而改善患者的预后。Biliary complication caused by hepatic cystic echinococcosis(HCE)intrabiliary rupture is one of the most common and serious complications of HCE,which is mainly diagnosed by its clinical manifestations and imaging examinations.Surgical treatment is the most effective method for intrabiliary rupture of HCE,which needs to decompress biliary tract,and keep the bile duct unobstructed on the basis of radical surgery or conservative surgery,and reasonably deal with the postoperative complications.Choledochotomy T-tube drainage is more commonly applied nowadays,and double T-tube drainage are placed in the fistula and the biliary tract.Endoscopic retrograde cholangiopancreatography,as an important preoperative and postoperative technique for intrabiliary rupture of HCE,can effectively remove the contents broken into the biliary tract and further reduce infection risk.This article reviews the clinical manifestations,diagnosis,and treatment of biliary complications of HCE,with the aim of improving the prognosis by early detection,diagnosis,and treatment.

关 键 词：棘球蚴病 肝 胆道并发症 内镜逆行胰胆管造影术 诊治 

分 类 号：R532.32[医药卫生—内科学]