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目的 探讨小儿先天性胆管囊肿的诊断和选择合理的手术术式。方法 回顾分析我院 1980年 1月至1999年 6月收治的 42例小儿先天性胆管囊肿的临床表现、辅助检查、手术术式和疗效。结果 具有三联征者占 3 8 1% ;B超确诊率为 95 2 % ;囊肿内引流术优良率显著低于囊肿切除术 (χ2 =19.3 6,P <0 0 0 1) ,再手术率和癌变率却显著高于囊肿切除术 (χ2 =11.5 9,P <0 0 0 1和 χ2 =4.97,P <0 0 5 )。结论 B超应列为首选检查方法 ;囊肿内引流术应废用 ;囊肿切除肝总管空肠Roux Y吻合术应为肝外胆管囊肿的首选术式 ;肝移植术是治疗弥漫性肝内胆管囊肿的合理选择。
Objective To investigate the diagnosis and selection of reasonable surgical procedure for congenital biliary cyst in children. Methods A retrospective analysis of our hospital from January 1980 to June 1999 admitted 42 cases of children with congenital cholangiocarcinoma clinical manifestations, laboratory examinations, surgical procedures and efficacy. Results The patients with triad symptoms accounted for 381%. The diagnosis rate of B ultrasonography was 95.2%. The excellent rate of drainage in cyst was significantly lower than that of cyst excision (χ2 = 19.36, P <0.01) The canceration rate was significantly higher than cyst excision (χ2 = 11.59, P <0.01 and χ2 = 4.97, P <0 05). Conclusions B-ultrasonography should be the preferred method of examination. Drainage in cysts should be used. Cyst excision of Roux-Y anastomosis should be the first choice of extrahepatic biliary cyst. Liver transplantation is a treatment for diffuse intrahepatic biliary cyst Reasonable choice.