成人先天性胆总管囊肿的诊断及治疗

目的 探讨成人先天性胆总管囊肿的诊断和治疗。方法 对收治的53例成人先天性胆总管囊肿病人进行分析。B超诊断正确率90．57％(48／53)。49例行囊肿切除和肝总管空肠Roux-Y吻合术。2例因癌变分别行肝门胆管癌根治术和胰十二指肠切除术。手术死亡率1．89％。结果 随访43例,随访率81．13％,平均随访32个月,约90％的病人能从事一般体力劳动,未观察到恶变者。结论 B超应作为先天性胆总管囊肿的首选检查,囊肿切除和肝总管空肠Roux-Y吻合术应作为首选术式,早期诊断,早期治疗,控制囊肿发展,减少并发症是改善先天性胆总管囊肿的关键。

Diagnosis and treatment of adult congenital bile cyst

Objective To analyze the diagnosis and treatment of adult congenital bile cyst.Methods Fifty three cases of adult congenital bile cyst were diagnosed by B-ultrasound,and the accuracy was 90.57%(48/53).Of all the 53 cases,excision of cyst and hepaticojejunostomy was done in 49.The mortality rate was 1.89%.Results Forty three cases were followed up for an average period of 32 months and no malignant changes was found.Conclusions B-ultrasound should be the first choice of examination while excision of cyst and hepaticojejunostomy be the first choice operation.Early diagnosis and treatment,control of cyst development and the decrease of complications played key roles in the prognosis of congenital bile duct cyst.