成人先天性胆管囊状扩张症52例诊治经验

目的 探讨成人先天性胆管囊状扩张症的诊断治疗经验.方法 回顾性分析我院2006年7月至2011年8月间收治的成人先天性胆管囊状扩张症52例的临床资料.结果 本组52例的临床表现为:腹痛45例(86.5％),黄疸18例(34.6％)、腹部包块7例(13.5％).所有患者均接受超声检查,其中47例显示胆总管囊肿或扩张.36例行CT检查,22例行ERCP检查获得确诊.手术方式主要为囊肿切除,胆管空肠Roux-Y行吻合胆道重建术,具体操作因胆管扩张症分型稍有差异.术后并发症主要为胆道感染,经抗生素治疗后痊愈.全组无手术死亡病例,术后囊肿发生癌变2例.结论 成人先天性胆管扩张症常见临床表现为腹痛、黄疸、腹部包块.B超、CT、ERCP等影像学检查是其术前诊断的重要手段.手术方式采用囊肿切除、胆管空肠Roux-Y行吻合胆道重建术.

The experience of diagnosis and treatment of 52 cases of adults congenital choledochocele

Objective To investigate the diagnosis and treatmentof adult congenital choledochocele.Methods The clinical data of 52 adult patients from July 2006 to August.2011 were retrospectively analyzed.Results Clinical manifestations were mainly epigastralgia(45/52,86.5%),jaundice(18/52,34.6%) and abdominal mass(7/52,13.5%).All cases underwent ultrasonic diagnosis and cyst or dilatation of common bile duct was detected in 47 cases.CT performed in 36 cases and ERCP in 22 cases,all confirmed the diagnosis.All cases underwent surgical therapy.The main operation method was resection of extrahepatic cyst and cholangiojejunostomy.Postoperative complication was mainly retrograde infection of biliary tract,which could be controlled by the administration of antibiotics.There was no perioperative mortality.Conclusion The common clinical manifestations of adult congenital choledochocele ware abdominal pain,jaundice,abdominal mass.Imaging examination is the important measure of early diagnosis.Resection of the cyst and cholangiojejunostomy can achieve satisfactory curative effect.