36例胆内瘘的诊断与治疗

目的 探讨胆内瘘的诊断及治疗方法。方法 对1990年1月至2006年6月收治的36例胆内瘘患者进行回顾性分析。结果 术前明确诊断7例,占19.4%;胆内瘘类型：胆囊十二指肠瘘19例,胆囊结肠瘘10例,胆囊胃瘘2例,胆囊肝总管瘘4例,胆总管十二指肠瘘1例;所有病人均行手术治疗,痊愈出院。结论 胆内瘘术前诊断困难,漏诊率高;胆内瘘手术原则为切除胆囊、修补瘘口、通畅引流。

Diagnosis and treatment of internal biliary fistula in 36 cases

Objective To investigate the methods of diagnosis and treatment of internal biliary fistula.Methods The data of 36 patients with internal biliary fistula from Jan.1990 to Jun.2006 were analyzed retrospectively.Results 19.5%(7/36)patients with internal biliary fistula were diagnoseed before operation.In these patients with biliary fistula,19 cases were gallbladder duodenum fistula,10 cases were gallbladder colon fistula,2 cases were gallbladder stomach fistula,4 cases were gallbladder common hepatic duct fistula,1 case was duodenum common bile duct fistula.All these patients were operated,did well postoperatively and were discharged to home.Conclusion Preoperative diagnosis of biliary fistula is a embarrassed problem with high rate of missed diagnosis.The operative principle of internal biliary fistula includes cholecystectomy,fistula repair,and biliary tract drain.