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[非闭锁性原因引起的肝外胆汁淤积。新的诊断和治疗可能性]

[Extrahepatic cholestasis of nonatretic origin. New diagnostic and therapeutic possibilities].

作者信息

Broto J, Marhuenda C, Casasa J M, Gil Vernet J M, Pérez A, Boix Ochoa J

机构信息

Departamento de Cirugía Pediátrica, Hospital Materno-Infantil Valle Hebrón, Barcelona.

出版信息

Cir Pediatr. 1990 Oct;3(4):168-72.

PMID:2076365
Abstract

Nonatretic cholestatic disorders exhibit differential features in the pediatric age group, at times not too obvious but always discernible. These characteristic differences, with the aid of increasingly more precise exploratory techniques, make a rapid and sound diagnosis possible. At present, echography, transparietohepatic cholangiography and endoscopic retrograde cholangiography allow us, within a short time, to reach a diagnosis of disorders that not long ago were only roughly profiled and on occasion were left undiagnosed. At the Children's Hospital Valle de Hebrón, treatment has been afforded, in the last seven years, to seven patients with a choledochal cyst, four with a long common biliopancreatic duct, one with a choleperitoneum due to spontaneous perforation of a choledochal cyst and one patient with congenital stenosis of the common hepatic duct. In all cases where echography was performed, an intra- or extrahepatic bile duct dilatation could be demonstrated, or otherwise the diagnosis of a choledochal cyst was established. Furthermore, four transhepatic and three retrograde cholangiographic examinations were carried out, via a fiber duodenoscopy, in those cases that failed to show, on echography, the existence of a choledochal cyst.

摘要

非闭锁性胆汁淤积性疾病在儿童年龄组中表现出不同的特征,有时不太明显,但总是可以辨别的。借助越来越精确的探索技术,这些特征差异使得快速而准确的诊断成为可能。目前,超声检查、经皮肝穿刺胆管造影和内镜逆行胆管造影使我们能够在短时间内对不久前还只是大致描述且有时未被诊断出来的疾病做出诊断。在瓦尔德希伯伦儿童医院,在过去七年里,共治疗了7例胆总管囊肿患者、4例胆胰管共同管过长患者、1例因胆总管囊肿自发穿孔导致胆汁性腹膜炎的患者以及1例先天性肝总管狭窄患者。在所有进行超声检查的病例中,均显示有肝内或肝外胆管扩张,否则即确立胆总管囊肿的诊断。此外,对于那些超声检查未显示存在胆总管囊肿的病例,通过纤维十二指肠镜进行了4例经皮肝穿刺胆管造影和3例逆行胆管造影检查。

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