Atkinson John J, Davenport Mark
Department of Paediatric Surgery, Kings College Hospital, London, UK.
S Afr Med J. 2014 Oct 24;104(11):816-819. doi: 10.7196/samj.8633.
Choledochal malformations (some of which are choledochal cysts) may be characterised as an abnormal dilatation of the biliary tract, in the absence of acute obstruction. Most do appear to be of congenital origin, probably related to distal bile duct stenosis, and almost 15% can now be detected antenatally.Excision and biliary reconstruction using a Roux loop as an open operation is still the standard to compare against, although laparoscopic reconstruction is increasingly reported. This article discusses recent advances in the understanding of choledochal malformation aetiology and classification, together with the role of newer modalites of surgical treatment such as laparoscopic excision and biliary reconstruction. Although these are definitely feasible, care should be taken before dispensing with standard open techniques that have minimal complications and proven long-term benefit.
胆管畸形（其中一些是胆管囊肿）的特征可能是在没有急性梗阻的情况下胆管异常扩张。大多数似乎是先天性起源，可能与远端胆管狭窄有关，现在几乎15%可以在产前检测到。使用Roux袢进行开放手术切除并重建胆道仍然是作为对照的标准方法，尽管越来越多的报道采用腹腔镜重建。本文讨论了在胆管畸形病因学和分类理解方面的最新进展，以及腹腔镜切除和胆道重建等新的手术治疗方式的作用。虽然这些方法肯定可行，但在摒弃具有最低并发症和已证实的长期益处的标准开放技术之前应谨慎行事。
