残余胆囊的诊治

目的 探讨残余胆囊的诊治及预防。方法 残余胆囊切除4例，残余胆囊切除、胆总管探查、T管引流术10例，残余胆囊切除、肝胆管空肠Roux-Y吻合术2例，EST3例，EST后残余胆囊切除1例。结果 近远期疗效佳19例，欠佳1例，无手术死亡。结论 ERCP是诊断残余胆囊及并存病的最佳检查方法，无结石和胆囊管梗阻的残余胆囊并非一定需切除，重视每一例胆囊切除术、精细解剖、必要时经胆囊管胆道造影检查可以预防残余胆囊及残留结石发生。

The diagnosis and therapy of the residual gallbladder after cholecystectomy

Objective To investigate the diagnosis,therapy and prevention of residual gallbladder.Methods Residual cholecystectomy was performed on 4 cases,residual cholecystectomy and choledochostomy on 10 cases,residual cholecy stectomy and Roux-en-y hepatico-jejunostomy 2 cases,Endoscopic sphincterotomy (EST) on 3 cases,EST and residual cholecystectomy on 1 case in our hospital from Jan 1990 to May 2002,were analyzed retrospectively.Results The short and long-term results were satisfactory in 19 patients,there wasn't,tpostoperative death.Conclusion Endoscopic retrograde cholangio pancreatography (ERCP) is optimal in diagnosing the disease.If it wasn't lithiasis or obstruction in cystic duct,the residual gallbladder needn't resecting.Careful operation,clear anatomy of Calot's triangle and intraoperative cholangiography by cystic duct could prevent the residual gallbladder.