Ohi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T
Division of Pediatric Surgery, Tohoku University, School of Medicine, Sendai, Japan.
J Pediatr Surg. 1990 Jun;25(6):613-7. doi: 10.1016/0022-3468(90)90346-b.
The surgical treatment of 100 cases with congenital dilatation of bile duct with special reference to late complications was analyzed. There were no deaths nor occurrences of malignancy. Among 91 patients who had undergone the standard operation, namely total excision of the dilated extrahepatic bile duct and reconstruction after Roux-en-Y hepaticojejunostomy, there were one early complication (pancreatic juice leakage) and five late complications (four intrahepatic gallstones and one liver abscess). The cause of intrahepatic gallstone formation after a total excisional operation was attributed to the remaining intrahepatic bile duct dilatation and the stenosis located between the intrahepatic bile duct dilatation and the common hepatic duct. Accordingly, these results support the total excisional procedure for this condition; however, with regard to the cases associated with cystic dilatation of intrahepatic bile ducts, completely free bile drainage from the dilated intrahepatic biliary system should be performed at the radical operation.
对100例先天性胆管扩张症患者的手术治疗进行了分析，特别关注晚期并发症。无死亡病例，也未发生恶性肿瘤。在91例接受标准手术（即完全切除扩张的肝外胆管并在Roux-en-Y肝空肠吻合术后重建）的患者中，有1例早期并发症（胰液漏）和5例晚期并发症（4例肝内胆结石和1例肝脓肿）。完全切除术后肝内胆结石形成的原因归因于残留的肝内胆管扩张以及肝内胆管扩张与肝总管之间的狭窄。因此，这些结果支持对此病采用完全切除手术；然而，对于合并肝内胆管囊性扩张的病例，在根治性手术时应确保扩张的肝内胆管系统完全通畅引流胆汁。
