CAJ | 학술논문

目的分析先天性胆管囊肿患者再手术原因,降低再手术率,提高首次手术疗效.方法统计分析我院自1997年4月-2008年4月收治的168名先天性胆管囊肿患者的临床资料,比较不同年龄、性别、首次手术时机、首次手术方式的患者的再手术率.结果不同年龄、性别的患者再手术率并无明显差异；首次手术为急诊手术的患者再次手术率为63.79％,择期手术患者再手术率仅为31.82％,两组比较差异有显著性(P＜0.05)；在各种术式中,囊肿切除并肝管空肠Roux-en-Y吻合术再手术率最低,仅为31.43％,与其他各组比较差异有显著性(P＜0.05).结论患者在初诊为该病时应尽可能行手术根治,避免后期急性发作被迫行急诊手术；囊肿切除并肝管空肠Roux-en-Y吻合术是首选术式,内引流术应淘汰,外引流术仅在不能耐受复杂手术的急诊患者中应用,为二期手术做准备.
목적 분석선천성담관낭종환자재수술원인,강저재수술솔,제고수차수술료효.방법 통계분석아원자1997년4월-2008년4월수치적168명선천성담관낭종환자적림상자료,비교불동년령、성별、수차수술시궤、수차수술방식적환자적재수술솔.결과 불동년령、성별적환자재수술솔병무명현차이；수차수술위급진수술적환자재차수술솔위63.79％,택기수술환자재수술솔부위31.82％,량조비교차이유현저성(P＜0.05)；재각충술식중,낭종절제병간관공장Roux-en-Y문합술재수술솔최저,부위31.43％,여기타각조비교차이유현저성(P＜0.05).결론 환자재초진위해병시응진가능행수술근치,피면후기급성발작피박행급진수술；낭종절제병간관공장Roux-en-Y문합술시수선술식,내인류술응도태,외인류술부재불능내수복잡수술적급진환자중응용,위이기수술주준비.
Objective To lower the rate of repeat surgery and enhance the efficacy of initial surgery by analyzing the causes of repeat surgery for congenital choledochal cyst.Methods The clinical data on 168 patients with congenital choledochal cyst who had been hospitalzed during the period of April 1997 to April 2008 were analyzed retrospectively.The differences in age,gender,timing and procedures of initial,and rates of repeat surgery were compared.Results There was no significant difference in the rate of repeat surgery among different groups of age or gender.The rate of repeat surgery differed significantly between the patients undergoing emergent surgery as the initial treatment and those undergoing selective surgery ( 63.79％ vs.31.82％,P＜ 0.05 ).In all of the surgical procedures,cyst removal plus Roux-en-Y cholangiojejunostomy had a lowest rate of repeat surgery ( 31.43％ ).Conclusions In order to avoid emergent surgery,surgical treatment should be administered as early as possible once the diagnosis of congenital choledochal cyst is established.Cyst removal plus Roux-en-Y cholangiojejunostomy is the first choice.Internal drainage should be abandoned and external drainage can only be used in those who are not tolerated to complicated procedures.