先天性胆总管囊肿手术治疗经验

目的：总结先天性胆总管囊肿的手术治疗经验。方法：对194例先天性胆总管囊肿的手术治疗经验进行回顾性分析。结果：194例均行囊肿切除，胆道重建术：（1）肝管十二指肠吻合术4例；（2）间置空肠肝管十二指肠吻合术（人工乳头）15例；（3）间置胆囊肝管十二指肠吻合术4例；（4）肝管空肠Roux-en-Y型吻合术171例。本组190例术后恢复顺利，手术死亡4例（2．06％）。结论：囊肿可使胆汁流入胰管内并发胰腺炎，囊肿易癌变，囊肿可形成盲袋和死腔易形成结石，故囊肿切除胆道重建术是治疗先天性胆总管囊肿的最佳选择。尽管胆道建术式较多，但以肝总管空肠Roux-en-Y型吻合术是胆道重建术的一种理想手术。

Experience in surgical treatment of congenital choledochal cysts

Objective To summarize the experience in surgical treatment of congenital chole- dochal cysts.Methods Clinical data of 194 patients with congenital choledochal cysts surgically trea- ted in our hospital were retrospectively analyzed.Results All the 194 patients were subjected to re- section of choledochal cysts and biliary tract reconstruction:(1)hepaticoduodenostomy in 4;(2)in- terposed jejunal hepaticoduodenostomy in 15;(3)interposed cholecyst hepaticoduodenostomy in 4; (4)Roux-en-Y hepaticoduodenostomy in 171.After the treatments,190 patients recovered smoothly and 4 died(2.06%).Conclusions Congenital choledochal cysts can cause bile inflow into the pancre- atic duct to result in stone and canceration.Thus resection of choledochal cysts and biliary tract recon- struction are the optimal choice for treatment of congenital choledochal cysts.Roux-en-Y hepaticoduo- denostomy is a perfect operation of biliary tract reconstruction.