摘要
目的 观察先天性胆总管囊肿的囊肿切除后阑尾间置重建胆道的远期效果。方法 对患儿的临床表现、必要的生化检查、B型超声、钡餐以及 SPECT的结果进行手术前后及远期对比综合分析评价。结果 13例中发育营养佳 ,肝功能正常 ,无任何症状者 12例 ,占 92 .3 % ,仅 1例虽发育营养佳 ,但偶有能自行缓解的上腹剑突下疼痛 ,所有的 B型超声检查无肝内胆管扩张和积气 ,SPECT检查间置胆道显影清晰、流经通畅、肠道显影 ,GI检查无返流。结论 先天性胆总管囊肿切除阑尾间置重建胆道 10年随访效果好 ,只要手术中阑尾无病变 ,其系膜和动脉血管转移至肝门处无张力 ,阑尾间置重建胆道是一种可推荐的手术方法。
Objective To study the long-term results of vascularized appendiceal transplants in biliary tract after choledochal cyst excision.Methods The pre-and-postoperative clinical manifestation,biochemistry examination,B-ultrasonography(B-US),upper gastrointestinal(GI) X-ray series and single proton ejected computerized tomography(SPECT) scanning of children with choledochal cyst were contrasted and evaluated comprehensively.Results 13 cases were followed up for a period of 4～10 years,12 of them are growing and developing well without any symtoms(92.3%),one had only abdominal pain.All the dilated intrahepatic bile ducts had become normal presented by postoperative B-US.Biliary ducts were reconstructed fluently and manifested clearly on SPECT,and no one had reflux on GI examination.Conclusion We find it is advantegeous to reconstruct biliary ducts using pedicled appendix as a kind of interposition material.We recommend it is an important way for the treatment of choledochal cyst except the appendix is diseased or the length of the vascular pedicle is inadequate.
出处
《肝胆外科杂志》
2001年第4期254-256,共3页
Journal of Hepatobiliary Surgery
