妊娠期胆总管囊肿的诊治分析..docVIP

妊娠期胆总管囊肿的诊治分析 】目的探讨妊娠期胆总管嚢肿的临床特征、诊 断和治疗方案。方法收集自XX年以来收治的3例妊娠期胆 总管囊肿的临床资料，进行随访与回顾性分析。结果3例患 者均为I型胆总管囊肿，术前均有急性胆管炎发作史，1例 患者孕22周因严重的胆管炎经非手术治疗无效而急诊行胆 总管T管外引流术，术后出现先兆流产而行引产，于术后3 月行囊肿切除胆管空肠Roux-Y吻合术。另2例均发生于妊 娠晚期，经非手术治疗控制胆管炎症状后，继续妊娠，于足 月剖腹产后第6天及2周行囊肿切除胆管空肠Roux-Y吻合 术。3例患者随访至今均情况良好。结论妊娠期胆总管囊肿 以B超作为首选检查手段，对于B超无法确诊的患者，可选 用MRCP，妊娠期无症状者以随访为主，待分娩后再行胆总管 囊肿切除术；对于有症状而经非手术治疗无效者，行胆总管 T管外引流术，分娩后再行囊肿切除术。 关键词】胆总管囊肿妊娠外科手术 Analysis ofdiagnosisandtrea tmentofcongenitalc holedochalcystinpregnancyAbstractsthee1 inicalfeaturtmentmethodforcong ystinpregnancies. MObjective Todiscus e,diagnosisandtrea holedochalcystinpregnancy Abstract sthee1 inicalfeatur tmentmethodforcong ystinpregnancies. M Objective Todiscus e,diagnosisandtrea enitaicholedochalc ethods Thee1 inical therapytocontrolth tpregnaneyuntilful ectivelyunderwentc x-Ycholangio-jejun 4thdayaftercesarea therapytocontrolth tpregnaneyuntilful ectivelyunderwentc x-Ycholangio-jejun 4thdayaftercesarea resultsshowedthatt lverywelluptonow. C dataofthreepatient s,diagnosedofconge nitalcholedochalcy stinpregnancywerec ollectedsinceXX. Fo 1low-upandretrospe ctiveanalysisw e r e c arriedout. Results Threepatientswerea lldiagnosedastype I thacutecholangitis sgivenaT- lldiagnosedastype I thacutecholangitis sgivenaT-tubebilia choledochalcystswi .Thefirstpatientwa rydrainageemergent lybecauseoftheseriouscholangEitisinh er22weeks lybecauseoftheseri pregnane yafterconservative treatment. Postoper atively， shewasdiag nosedofthreateneda bortionandthenwasg iveninducedlabor. T hreemonthslater,th epatientacceptedcy -Ycholangio-jejunostresectionandRoux epatientacceptedcy -Ycholangio-jejuno stresectionandRoux stomy. Theothertwop atientsbothdiagnos edofthesamedisease inlatepregnantstag e (34weeksand36week s,respectively) ac ceptedconservative echolangitisandkep lterm. Thentheyresp ystresectionandRou ostomyonthe6thandl nsection. Follow-叩 hreepatientswereal one1us i on Buitrasoundshouldbeconside one1us i on Buitraso undshouldbeconside redastherecommende dtestindi