27例成人先天性胆管扩张症诊疗分析.docVIP

精品论文 参考文献 27例成人先天性胆管扩张症诊疗分析 陈燕 (四川省凉山州第一人民医院 615000) 【摘要】目的：探讨成人先天性胆管扩张症的诊断和治疗。方法：对我科2000-2010年收治的27例成人先天性胆管扩张症患者的诊断和治疗进行回顾性分析。结果：B超诊断准确率88.9%(24/27)，核磁共振胰胆管造影术(magneic resonance cholangiopancreatograph,MRCP)检查16例均确诊。23例行囊肿切除和肝总管空肠Roux_Y吻合术，1例合并癌变行胰十二指肠切除术，术后2例合并胆漏，1例合并胰漏。随访20例，随访率74.1%，平均随访34个月，约90%患者能正常工作，无恶变者。结论：B超作为诊断诊断先天性胆管扩张症首选检查，MRCP有助于临床分型及指导手术。囊肿切除和肝总管空肠Roux_Y吻合术作为首选治疗。早期诊断、早期根治性治疗，减少并发症是治疗成人先天性胆管扩张症的关键。 【关键词】先天性胆管扩张症 成人 诊断 治疗 【中图分类号】R575.7 【文献标识码】A 【文章编号】2095-1752（2014）19-0203-02 【Abstract】 Objective: To investigate the diagnosis and treatment of adult congenital bile duct dilatation.Method: Diagnosis and treatment of 27 adult patients with congenital bile duct dilatation treated since 2000 to 2010 were retrospectively analyzed. Result: Diagnosticaccuracy rate of B-mode ultrasonography were 88.9%(24/27), magnetic resonance cholangiopancreatography (magneic resonance cholangiopancreatograph, MRCP) examination 16 cases were diagnosed.23 routine cyst resection and hepatic duct jejunum Roux Y anastomosis, Postoperative 1 patient with pancreatic cancer line of resection, 2 patients with bile leakage, and 1 with pancreatic leakage.Follow-up of 20 cases, follow-up rate of 74.1%, with an average follow-up of 34 months, about 90% of patients can work, no malignant.Conclusion: B ultrasound as a diagnostic of choice for the diagnosis of congenital bile duct dilatation examination, MRCP contribute to the clinical classification and guide surgery.Hepatic duct cyst resection and anastomosis of the jejunum Roux_Y as the preferred treatment. Early diagnosis and radical treatment to reduce complications is the key to treatment of adult congenital bile duct dilatation. 【Key word】Congenital bile duct dilatation Adult Diagnosis Treatment 先天性胆管扩张症是一种先天性胆管发育异常的疾病，是指肝内或(和)肝外胆管的先天囊状、梭状或憩室状扩张。发病率不高，女性多于男性。本文回顾分析我院2000-2010年收治的27例成人先天性胆管扩张症，现报告如下。