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成人Ⅰ型胆总管囊肿的腹腔镜切除术及 Roux-en-Y 肝空肠吻合术:一例报告及文献复习

Laparoscopic resection of type I choledochal cyst in an adult and Roux-en-Y hepaticojejunostomy: a case report and literature review.

作者信息

Abbas Hasan M H, Yassin Nuha A, Ammori Basil J

机构信息

Department of Surgery, Manchester Royal Infirmary, Manchester, UK.

出版信息

Surg Laparosc Endosc Percutan Tech. 2006 Dec;16(6):439-44. doi: 10.1097/01.sle.0000213768.70923.99.

Abstract

Choledochal cysts are rare cystic dilatations of the extrahepatic biliary tree, the intrahepatic bile ducts, or both and carry a substantial risk of malignant transformation. Type I choledochal cysts, which involve the entire common hepatic and common bile ducts, represent 80% to 90% of these lesions. We report laparoscopic excision of symptomatic type I choledochal cyst in a 37-year-old woman, and review the literature. Laparoscopic excision of the extrahepatic biliary tree from the hepatic confluence to the anomalous pancreatobiliary junction with en bloc cholecystectomy and reconstruction with a Roux-en-Y hepaticojejunostomy was accomplished. Postoperative recovery was uneventful with a hospital stay of 3 days. She remains well and asymptomatic at 6 months of follow-up. Laparoscopic excision of choledochal cysts may be safely accomplished with a prompt recovery. Further experience with this approach in larger number of patients is justified and long-term follow-up data are needed.

摘要

胆总管囊肿是肝外胆管树、肝内胆管或两者的罕见囊性扩张,具有较高的恶变风险。I型胆总管囊肿累及整个肝总管和胆总管,占这些病变的80%至90%。我们报告了一例37岁女性有症状的I型胆总管囊肿的腹腔镜切除术,并复习了相关文献。通过腹腔镜从肝汇合处至异常胰胆管交界处切除肝外胆管树,并整块切除胆囊,再行Roux-en-Y肝空肠吻合术重建。术后恢复顺利,住院3天。随访6个月时,她情况良好,无症状。腹腔镜切除胆总管囊肿可安全完成,且恢复迅速。对更多患者采用这种方法进行进一步研究是合理的,并且需要长期随访数据。

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