【摘要】 目的:探讨成人胆总管囊肿的诊断和治疗。方法:收集2004年5月—2009年5月收治的72例成人胆总管囊肿患者临床资料,其中男20例,女52例,年龄18~67岁(平均31岁)。Ⅰ型41例,Ⅳa型28例,Ⅳb型3例,无其他类型患者。4例囊肿癌变患者因多发脏器受累未能行手术治疗,余68例均行手术治疗。1例行胰十二指肠切除术,1例行胆总管囊肿切除+左半肝切除术,余66例行胆总管囊肿切除+肝管空肠Roux-en-Y吻合术,其中17例联合肝部分切除术。结果:术后出现近期并发症者6例(8.8%)。随访1~8年,4例癌变未手术患者均于确诊后2年内死亡,8例(11.7%)出现远期并发症。结论:成人胆总管囊肿患者明确诊断后,应尽早手术,将囊肿完整切除术,达到改善患者生活质量、延长患者生存时间的目的,手术方式以胆总管囊肿切除+肝管空肠Roux-en-Y吻合为首选术式。更多还原

【Abstract】 Objective: To investigate the diagnosis and treatment of adult choledochal cyst.Methods: Clinical data,from May 2004 to May 2009,of 72 cases of adult choledochal cyst patients were analyzed retrospectively,including 6 cases complicated with malignant tumors in the cysts,among whom 4 cases did not receive surgical treatment for multiple organs invasion.In total,68 patients underwentsurgery.Of 72 patients(20 male and 52 female,with ages ranging from 18 to 67 years old;median age 31 years),the incidence rates for typeⅠ,Ⅳa and Ⅳb were 41,28 and 3,respectively.Majority of the patients(n=66)underwent complete cyst resection and Roux-en-Y hepaticojejunostomy,including 17 cases combined with partial hepatectomy.One patient received pancreaticoduo-denectomy and 1 routine choledochal cyst resection combined with left hepatectomy.Results: There was no surgical mortality,early and long-term postoperative complications occured in 6(8.8%)and 8 patients(11.7%)respectively.The follow-up time ranged from 1 to 8 years.Four cases with malignant choledocal cysts that had not undergone surgery died within 2 years after diagnosis.Conclusion: The identification and early diagnosis of choledochal cyst is very important in preventing future complications.We recommend complete cyst resection and Roux-en-Y hepaticojejunostomy as the procedure of choice to extend patient’s survival time and improve their quality of life.更多还原