Todani T, Watanabe Y, Fujii T, Toki A, Uemura S, Koike Y
Arch Surg. 1984 Sep;119(9):1038-43. doi: 10.1001/archsurg.1984.01390210042010.
We reviewed congenital choledochal cyst with intrahepatic involvement in 38 patients aged 52 days to 29 years. Dilatations were classified into the following three forms, based on the shape of the extrahepatic and intrahepatic bile duct: cystic-cystic, cystic-cylindrical, and cylindrical-cylindrical. Stenosis of the hepatic duct near the hilum probably does not cause dilatation of the intrahepatic duct. The anomalous arrangement of the pancreatobiliary union seems to determine only the form of extrahepatic dilatation, and cystic dilatation of the intrahepatic duct may be caused by some other factors. Total excision of the extrahepatic bile duct with the creation of a wide anastomotic stoma apparently is the treatment of choice. Hepatectomy would be recommended for some patients with the cystic-cystic form.
我们回顾了38例年龄在52天至29岁之间的先天性胆管囊肿合并肝内受累的病例。根据肝外和肝内胆管的形态，扩张分为以下三种类型：囊肿-囊肿型、囊肿-圆柱型和圆柱-圆柱型。肝门附近肝管的狭窄可能不会导致肝内胆管扩张。胰胆管合流异常似乎仅决定肝外扩张的形式，而肝内胆管的囊性扩张可能由其他一些因素引起。显然，肝外胆管全切除并建立宽大的吻合口是首选的治疗方法。对于一些囊肿-囊肿型的患者，建议行肝切除术。
