Le Borgne J, Lehur P A, Guiberteau-Canfrere V, Bitar O, Lerat F, Gibaud H
Clinique chirurgicale II, Hôpital G-et-R-Laënnec, Nantes.
Chirurgie. 1994;120(4):181-5; discussion 186.
Ten cases of complications of simple biliary cysts were reported: 4 intracystic haemorrhages including 1 intraperitoneal rupture, 3 bacterial infections including 1 case with invalidating pain. Complications of biliary cysts raises the problem of the differential diagnosis with cysts caused parasites, neoplastic processes (cystadenomas and pseudocysts of the liver) and with intrahepatic collections of pancreatic or traumatic origin. Imaging and echo-guided puncture are the most appropriate exploration techniques. MRI has been particularly helpful to evaluate bleeding in an intrahepatic cyst. A pathology examination of the cyst wall and its contents should always be performed. Theoretically, partial cystectomy (performed here in 8 cases) is the indicated treatment. Total cystectomy (1 case) is justified when the diagnosis of cystadenoma cannot be excluded. The role of liver resection is very limited. Preventive resection of a simple biliary cyst greater than 8 cm can be indicated, particularly with videolaparoscopy.
报告了10例单纯性胆管囊肿的并发症：4例囊内出血，其中1例腹腔内破裂；3例细菌感染，其中1例疼痛无效。胆管囊肿的并发症引发了与寄生虫引起的囊肿、肿瘤性病变（肝囊肿腺瘤和假性囊肿）以及胰腺或创伤性起源的肝内积液进行鉴别诊断的问题。影像学检查和超声引导下穿刺是最合适的探查技术。MRI对评估肝内囊肿出血特别有帮助。应始终对囊肿壁及其内容物进行病理检查。理论上，部分囊肿切除术（此处8例）是指定的治疗方法。当不能排除囊肿腺瘤的诊断时，全囊肿切除术（1例）是合理的。肝切除术的作用非常有限。对于大于8cm的单纯性胆管囊肿，可考虑进行预防性切除，特别是采用电视腹腔镜手术。
