先天性胆管扩张症远期疗效随访观察

目的 对先天性胆管扩张症术后５年以上获随访的９７例进行综合分析,探讨远期并发症的原因及防治措施,以提高远期疗效。方法 对患者的临床表现、必要的生化检查、Ｂ型超声、纤维胃十二怕镜及２４ｈ胃食管双ｐＨ监测结果进行综合评价。结果 ①发育营养侍,无任何自觉症状,检查无异常者５０例,或偶有上腹疼痛。胃纳不佳,检查无异常者２０例,共７０例（７２．１６％）为优。②发育营养良,偶有或时有上腹疼痛,经纤维内窥镜检查

Long-term followed-up of congenital biliary dilatation

Objective To explore the causes, prevention and treatments for long-term postoperative complications of congenital biliary dilatation (CBD) . Methods The clinical manifestation,biochemistry examination, B-ultrasonography, fiber gastroduodenoscopy, and gastroesophageal 24-hour double pH monitoring of 97 cases with CBD were evaluated comprehensively after operation. Results The patients was grouped under three heads,namely : 1)satisfactory group (n=70, 72.16 %) , whose nutritional state was near normal with occasional upper abdominal uncomfortableness or anorexia; 2) fine group (n=23 , 27.71 %) , in which 15 cases had bile regurgitational gastritis, superficial gastritis, duodenal bulbar inflammation under fiberscopic examination and 8 had hepatolith by B-ultrasonic examination.Two cases had hepatic cirrhosis and portal hypertension ( 2.06 % ) and 2 died of malignant degeneration ( 2.06 % ).Conclusions The long-term postoperative complications are related to operative procedure selection,complete cyst resection,stricture of anastomosis and duodenogastric regurgitation.A preoperative comprehensive understanding of the distribution of intra-and extrahepatic ducts, administering Roux-Y hepatojejunostomy after complete cyst excision, and keeping long-term postoperative follow-up are important to prevent and manage the postoperative complications in time.