成人先天性胆管囊状扩张症的诊治体会(附22例报告)

目的探讨成人先天性胆管囊状扩张症的诊断及治疗方法。方法回顾性分析我院1984年～2006年收治的成人先天性胆管囊状扩张症22例的临床资料。结果本组22例均行手术治疗。囊肿内引流术再手术率高。囊肿切除肝管空肠Roux-en-Y吻合术无再手术病例,术后并发胆管炎3例、胰腺炎1例、胆瘘1例,均经保守治疗痊愈。全组无手术死亡病例。结论成人先天性胆管囊状扩张症经术前影像学检查能明确分型。单纯内引流术应摒弃,外引流术可为二期手术创造条件。囊肿切除肝管空肠Roux-en-Y吻合术为根治性术式。

The diagnosis and treatment of adult congenital cholangiectasis: A report of 22 cases

Objective To summarize the diagnosis and treatment of adult congenital cholangiectasis.Methods Twenty-two inpatients with adult congenital cholangiectasis from 1984 to 2006 were retrospectively analyzed.Results All 22 cases underwent operations,and the rate of reoperation in cyst internal drainages group was higher.There was no reoperation in cases who underwent jejuno-hepatic duct Roux-en-Y anastomosis combined with cyst excision and the complications included cholangitis(3/17),pancreatitis(1/17)and biliary fistula(1/17),which were cured by conservative treatment.There was no operative death.Conclusion Imageological examination could identify the grouping of the adult congenital cholangiectasis.The cyst internal drainages should be abandoned.Cyst external drainages can create the condition for the reoperation.Jejuno-hepatic duct Roux-en-Y anastomosis with cyst excision is radical operation.