【摘要】 目的探讨小儿先天性胆总管囊肿的临床手术方法与治疗效果。方法回顾性研究2005年8月至2011年8月手术治疗的先天性胆总管囊肿(胆管扩张症Ⅰ型)30例,其中男性8例,女性22例,年龄6个月～15岁。全组病例均常规采用二维CT检查和B型超声检查,对部分患儿采用磁共振胆胰管造影及三维彩色B超检查,确诊后根据病情行囊肿-空肠Roux-Y吻合术11例;囊肿及胆囊切除、肝总管-空肠Roux-Y吻合术19例。术后实行常规输液、营养、抗感染、支持治疗。结果获访病例中,行囊肿-空肠Roux-Y吻合术患者,9例远期出现反复腹痛、黄疸与发热症状;行囊肿及胆囊切除、肝总管-空肠Roux-Y吻合术患者,仅有1例远期出现了腹痛症状、1例发生粘连性肠梗阻,无胆管炎及胆管狭窄并发症出现。结论在技术娴熟的情况下,对患儿采用囊肿及胆囊切除、肝总管-空肠Roux-Y吻合术,是治疗小儿先天性胆总管囊肿的最佳手术方法。急诊患者应避免囊肿-空肠Roux-Y吻合,短期的过渡性囊肿外引流,然后尽快做根治手术。更多还原

【Abstract】 Objective To analyze and investigate children with congenital choledochal cyst clinical surgical techniques and therapeutic effect.Methods We selected hospital treatment of children with congenital choledochal cyst patients in August 2005 to August 2011,30 cases,including 12 males and 18 females,aged 6 months-15 years old.All the patients were used routinely in two-dimensional CT and B-mode ultrasound examination on the part of cases using magnetic resonance cholangiopancreatography and three-dimensional color ultrasound B after diagnosis,according to the condition OK cyst-jejunal Roux,-Y anastomosis in 11 cases;for cysts and cholecystectomy,19 cases of hepatic duct-jejunum Roux-Y anastomosis.A routine postoperative infusion,nutrition,anti-inflammatory,support treatment.Results The follow-up,line Roux-Y cyst-the jejunum anastomosis patients,9 cases of complications,including repeated abdominal pain,jaundice and fever symptoms,Do cyst and gallbladder excision-the hepatic jejunum Roux-Y anastomosis patients,only 1 case appeared abdominal pain symptoms,1 case of adhesion ileus,no cholangitis and bile duct stenosis complications.Conclusion In skilled cases,Do cyst and gallbladder excision-the hepatic jejunum Roux-Y anastomosis is the treatment of congenital choledochal cyst the best surgical method,Emergency patients should avoid cyst-jejunal Roux-Y anastomosis,the short-term transitional cyst and external drainage,and then as soon as possible to do radical surgery.更多还原