胆内瘘53例临床治疗分析

目的探讨胆内瘘的诊断及治疗方法。方法对1998年3月~2005年7月收治的53例胆内瘘患者进行回顾性分析。结果11.3%(6/53)的病人术前诊断为胆内瘘,88.7%(47/53)的病人为术中发现;在胆内瘘类型中,52.8%(28/53)为胆囊十二指肠内瘘,13.2%(7/53)为胆囊胃内瘘,15.1%(8/53)为胆囊横结肠内瘘,7.5%(4/53)为胆总管十二指肠内瘘,11.5%(6/53)为胆囊肝总管内瘘。胆石性肠梗阻占胆内瘘的7.5%。结论胆内瘘术前诊断困难,对长期胆囊结石病人,尤其是发现胆道积气征应高度怀疑,其治疗方法可采用胆总管瘘口、肝总管瘘口、十二指肠瘘口、横结肠瘘口修补等方法,对胃瘘口可采用瘘口修补或胃部分切除处理。

ANALYSIS OF CLINIC TREATMENT OF 53 CASES WITH BILIARY FISTULA

Objective To study the methods of diagnosis and treatment of biliary fistula.Methods A retrospective analysis was performed on the data of 53 patients with biliary fistula from May,1998 to July,2005.Results 11.3%(6/53) patients with biliary fistula were diagnosised before operation,while 88.7%(47/53) patients were diagnosised after the operation.In these patients with biliary fistula,52.8%(28/53) cases were gallbladder-duodenum fistula,13.2%(7/53) were gallbladder-stomach fistula,15.1%(8/53) were gallbladder-sigmoid fistula,11.5%(6/53) were gallbladder-common bile duct fistula,7.5%(4/53) were duodenum-common bile duct fistula.Conclusion Diagnosis of biliary fistula is a embarrassed problem,as far as chronic cholelithiasis is concerned,the sign of biliary duct with gas is one of criterion of diagnosis of biliary fistula.The methods of plasty can be used to treat the biliary fistula.