Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Clin Gastroenterol Hepatol. 2014 Feb;12(2):196-203. doi: 10.1016/j.cgh.2013.04.037. Epub 2013 May 6.
Choledochoceles are cystic dilatations of the intraduodenal portion of the common bile duct. Although often classified as Type III biliary cysts, choledochoceles have distinctive demographic and anatomic features and a lower risk of malignancy than other types of choledochal cysts. Type A choledochoceles are cystic dilatations of a segment of the intra-ampullary bile duct and are located proximal to the ampullary orifice. Type B choledochoceles are diverticula of the intra-ampullary common channel and are located distal to the ampullary orifice; they can be distinguished from duodenal duplication cysts both anatomically and histologically. Both types of choledochocele may present with pancreatitis, biliary obstruction, or nonspecific gastrointestinal symptoms. Cross-sectional imaging, endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography are useful for diagnosis. Choledochoceles may be drained or resected endoscopically. Surveillance for dysplasia should be considered for lesions that are not resected.
胆总管囊肿是胆总管十二指肠内段的囊性扩张。虽然胆总管囊肿常被归类为 III 型胆管囊肿，但与其他类型的胆总管囊肿相比，其具有独特的人口统计学和解剖学特征，恶性肿瘤风险较低。A型胆总管囊肿是壶腹内胆管某一段的囊性扩张，位于壶腹开口近端。B 型胆总管囊肿是壶腹内共同通道的憩室，位于壶腹开口远端；它们在解剖学和组织学上可与十二指肠重复囊肿相区别。两种类型的胆总管囊肿均可表现为胰腺炎、胆道梗阻或非特异性胃肠道症状。横断面成像、内镜超声和内镜逆行胰胆管造影术有助于诊断。胆总管囊肿可通过内镜进行引流或切除。对于未切除的病变，应考虑进行发育不良监测。
