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目的:探讨先天性胆总管囊肿(CCC)的诊断和治疗方法。方法:对1993年1月~2005年1月我院收治的35例CCC患儿的诊疗经过进行回顾性分析。结果:本组病例中33例病人均行择期手术,一期行胆囊切除、胆总管囊肿切除、肝管-空肠Roux-en-Y吻合术。为防返流,我们采用曾宪九氏防返流法,即:近端空肠与胆支臂空肠行同步并列缝合。2例因病人局部腹膜炎明显,一般情况差,先采用囊肿外引流术,3个月情况改善后行根治手术。35例治愈。随访26例患儿,仅1例偶有胆管炎。其余均无明显并发症。结论:B超是首选的检查手段,MRCP无创,检查方便,确诊率高,是较好的检查方法。囊肿切除、肝总管空肠Y吻合术是理想的手术方法,近端空肠与胆支臂同步并列缝合可有效防止反流性胆管炎。
Objective: To investigate the diagnosis and treatment of congenital choledochal cyst (CCC). Methods: The clinical data of 35 cases of CCC admitted to our hospital from January 1993 to January 2005 were analyzed retrospectively. Results: Thirty-three patients in this group underwent elective surgery. One was performed cholecystectomy, choledochal cyst excision, Roux-en-Y anastomosis. To prevent reflux, we used the anti-retrograde flow was nine times, namely: the proximal jejunum and gallbladder arm jejunum parallel parallel suture. 2 cases of patients with local peritonitis obvious, the general situation is poor, the first use of drainage outside the cyst, 3 months after the situation underwent radical surgery. 35 cases were cured. Twenty-six patients were followed up, with only 1 case of cholangitis occasionally. The remaining no significant complications. Conclusion: B-ultrasound is the preferred method of examination. MRCP is noninvasive, convenient for examination and high in diagnosis, which is a good method for examination. Cyst resection, hepaticojejunostomy Y anastomosis is an ideal surgical approach, the proximal jejunum and gallbladder arm synchronous parallel suture can effectively prevent reflux cholangitis.