19例胆囊十二指肠瘘的临床诊治分析

目的：总结胆囊十二指肠瘘的诊治经验。方法：回顾性分析2005~2010年8月收治的19例胆囊十二指肠瘘。结果：胆囊十二指肠瘘19例,术前诊断率为15.79%。19例全部手术治疗,合并胆石性十二指肠梗阻1例,回肠梗阻1例,合并胆总管结石3例,合并胆囊癌2例,合并胆管狭窄2例,均作相应的合并症处理,术后均恢复良好。结论：胆囊十二指肠瘘临床表现多样,术前诊断困难,疑有胆囊十二指肠瘘者应使用有效方法明确诊断。手术原则除了切除胆囊、胆管探查、切断瘘管、闭合瘘口外,妥善处理合并症也是关键,手术方式的选择应个体化。

Cholecystoduodenal Fistula an Clinical Analysis of 19 cases

Objective：To analyze the diagnosos and treatment of cholecystoduodenal fistula.Methods：The clinical data of 19 with cholecystoduodenal fistula treated at our hospital from 2005 to August 2010 were retrospectively analyzed.Results： The preoperative diagnosis rate of cholecystoduodenal fistula rate wad 15.79%.19 cases were treated by the selective operation in which one case was complicated with gallstone duodenal obstruction,and one case was complicated with ileocleisis,and 3 cases were complicated with choledocholithiasis,and 2 cases were complicated with carcinoma of the gallbladder,and 2 case were complicated with stenosis of bile duct.All of them recover well after operation.Conclusions：Cholecystoduodenal fistula presentde variously clinically,and preoperative diagnosis wad difficult.The effective way should be used to diagnose suspectde gallbladder fistula.In addition to surgical removal of gallbladder,bile duct exploration,cutting off the fistula,and closing duct of fistula,the surgical principle or the keys to success was to properly handle the complications and choose individual surgical methods.