CAJ | 학술논문

目的探讨成人胆囊管囊肿的诊断及治疗.方法回顾性分析1991-2012年收治的经手术证实的成人胆囊管囊肿25例的临床资料.结果本组25例患者均有慢性胆囊炎表现,其中14例右上腹反复发作性胆绞痛病史及恶心、呕吐等消化道症状;9例巩膜、皮肤黄染,并畏寒、高热.经彩超检查25例、ERCP 16例及MRCP 9例检查,均于胆囊管处显示直径1.6 cm×1.6 cm～2.5 cm ×2.5 cm液性暗区,23例其内有强光点,并同时存在胆囊扩张影,即所谓特征性类似“哑铃形”影像,其中23例B超检查发现胆囊内显示强光点.术前诊断:胆囊管囊肿伴结石或胆囊结石.术中所见基本同术前诊断一致.25例行胆囊和胆囊管囊肿联合切除术.术中2例损伤胆管并同时行肝管空肠Roux-en-Y吻合术.25例均痊愈.结论胆囊管囊肿是胆管囊肿分型的第Ⅵ型,临床上罕见,手术治疗效果优良.
목적 탐토성인담낭관낭종적진단급치료.방법 회고성분석1991-2012년수치적경수술증실적성인담낭관낭종25례적림상자료.결과 본조25례환자균유만성담낭염표현,기중14례우상복반복발작성담교통병사급악심、구토등소화도증상;9례공막、피부황염,병외한、고열.경채초검사25례、ERCP 16례급MRCP 9례검사,균우담낭관처현시직경1.6 cm×1.6 cm～2.5 cm ×2.5 cm액성암구,23례기내유강광점,병동시존재담낭확장영,즉소위특정성유사“아령형”영상,기중23례B초검사발현담낭내현시강광점.술전진단:담낭관낭종반결석혹담낭결석.술중소견기본동술전진단일치.25례행담낭화담낭관낭종연합절제술.술중2례손상담관병동시행간관공장Roux-en-Y문합술.25례균전유.결론 담낭관낭종시담관낭종분형적제Ⅵ형,림상상한견,수술치료효과우량.
Objective To explore the diagnosis and treatment of cystic dilatation of the cystic duct in adults.Method Clinical data of 25 cases of the cystic dilatation of cystic duct in adults in 3 hospitals in Songhuajiang river drainage area from 1991 to 2012 confirmed by surgery were analyzed retrospectively.Results The 25 cases were with manifestations of chronic cholecystitis,and 14 patients with right upper quadrant recurrent biliary colic and nausea,vomiting and other gastrointestinal symptoms,9 patients with yellowish discoloration of sclera and skin,and fever.Ultrasonography was done in 25 cases,ERCP in 16 cases and MRCP in 9 cases,displaying liquid dark area of diameter from 1.6 cm × 1.6 cm to 2.5 cm ×2.5 cm in the gallbladder tube suspective of calculi,and characteristic dumbbell shape image.Preoperative diagnosis was cystic duct cyst with stones or gallstones which was confirmed by surgery.Gallbladder and cyst resection was performed in all 25 cases,and bile duct jejunum Roux-en-Y anastomosis was done in 2 of these cases because of introgenic bile duct injury.Conclusions Cysts of the cystic duct is the special type (Ⅵ type) of choledochocele,and its prognosis is good after surgical treatment.