中国近21年成人先天性胆管扩张症流行学特征及诊治经验

目的：探讨成人先天性胆管扩张症的流行病学特征和诊疗经验。方法：联合检索维普数据库和中国期刊网等多家中文数据库中1990年1月～2010年11月有关成人先天性胆管扩张症的文章，总结分析成人先天性魍管扩张症的流行病学特征和诊治经验。结果：中国近2{年共报道5146例成人先天性胆管扩张症，有准确年龄及平均年龄报道4298例，平均年龄34．84岁，男女比例约为1：2．55，43．44％分布在华东地区，68．38％有不同程度腹痛表现，25．22％有发热或高热症状，32，46％有不同程度黄疸，18．31％可触及腹部包块，具有典型三联征表现患者占15．98％。Todani分型I型8041％，II型4．27％，III型123％，IV型1155％，V型占2，54％。手术治疗为主要治疗手段，胆管囊肿切除加胆管空肠Roux—en—Y吻合术占71．63％；术后并发症以胆管炎症状为主，发生率为12．24％；术后随访率83．55％，治愈率8684％。结论：成人先天性胆管扩张症女性多发，其中以华东地区较多，Todani分型I型为主，囊肿切除加胆肠Roux—en—Y吻合术为主要治疗手段。

Epidemiological feature and diagnosis and treatment of adult congenital biliary dilatation in China during the past 21 years

Objective: To study the epidemiological features of Adult Congenital Biliary Dilatation and its diagnosis and treatment.Methods: Reports on adult congenital biliary dilatation published from 1990 to 2010 were retrieved from various databases,such as China National Knowledge Infrastructure(CNKI),VIP.The epidemiological features of adult congenital biliary dilatation and its diagnosis and treatment were analyzed.Results: A total of 5146 patients with adult congenital bil-iary dilatation were reported in China during the last 21 years.The average ages and accurate ages were reported in 4298 cases,the average age of them was 34.84 years,male and female ratio is about 1:2.55,43.44% of the cases were located in East China,68.38% of the patients had varying degrees of abdominal pain,25.22% of patients have fever or symptoms of high fever,32.46% of patients with varying degrees of jaundice,18.31% patients with palpable abdominal mass,with the typical triad of the performance of patients accounted for 15.98%.Todani type Ⅰ-type accounts for 79.81%,Ⅱ-type accounted for 4.34%,Ⅲ-type accounted for 1.17%,Ⅳ-type accounting for 11.78%,Ⅴ-type accounting for 2.48%.Surgical treatment as the main treatment,bile duct cyst excision and bile duct jejunum Roux-en-YKiss surgery,accounting for 71.63%;postoperative cholangitis symptoms,the rate was 12.24%;postoperative follow-up rate of 83.55%,the cure rate 86.84 %.Conclusion: Adult women with congenital bile duct dilatation occur,mainly in eastern China,Todani type Ⅰ-based,biliary-enteric cyst excision + Roux-en-Y anastomosis as the main procedure of treatment.