胆囊十二指肠瘘30例临床分析

目的探讨胆囊十二指肠瘘诊治特点。方法对自2000年1月至2011年8月入住我院的30例胆囊十二指肠瘘患者的临床资料作回顾性分析。结果本组患者的主要症状为间断性右上腹疼痛,腹部超声检查发现胆囊结石25例,术前内镜逆行胰胆管造影(ERCP)检查确诊5例,上消化道泛影葡胺造影确诊2例,均进行手术治疗,术后十二指肠漏2例、胃肠吻合口漏2例,均治愈,1例术后发现瘘口处癌变。结论胆囊十二指肠瘘临床表现不典型,术前确诊困难,ERCP可明确诊断,术中处理易造成副损伤,应根据病情采取不同手术方式治疗。

The Clinic Analysis of 30 Cases of Cholecystoduodenal Fistula

Objective To evaluate the diagnosis and treatment of cholecystoduodenal fistula.Methods The clinical data of 30 inpatient cases were studied retrospectively from January 2000 to August 2011.Results The main symptom of the patients is intermittent right upper quadrant pain.25 cases were found with gallstones in B-mode ultrasound.The definite diagnosis were made,including 5 cases with ERCP and 2 cases with Diatrizoate contrast.The post-operation complications were 2 dudenal fistulas and 2 Gastrointestinal anastomotic leakages,which were all cured.1 case was found canceration.Conclusion The cholecystoduodenal fistula has atypical clinical manifestation,preoperaive diagnosis is difficult,and ERCP can make the accuate diagnosis.Encountering the different conditions in surgery,the different surgerical treament should be adopted.