Kasai M, Suzuki H, Ohi R
Jpn J Surg. 1977 Sep;7(3):147-50. doi: 10.1007/BF02469345.
Fifty one operations for choledochal cyst were carried out upon 46 patients: 41 as a primary operation and 10 as reoperation. An excision of choledochal cyst with hepaticojejunostomy in Roux-en-Y fashion at the second laparotomy gave a favorable results in all patients who suffered recurrent symptoms after the previous anastomotic procedure. Comparing operation time, blood loss and operative results of the reoperations with those of the primary, it was concluded that all choledochal cyst should be excised at the first operation unless other reason avoiding excision exists. Hepatic portojejunostomy is recommended for choledochal cyst with an associated distal atresia and the hypoplastic hepatic duct.
对46例患者实施了51例胆总管囊肿手术:41例为初次手术,10例为再次手术。对于所有在前次吻合手术后出现复发症状的患者,在第二次剖腹手术时采用Roux-en-Y式肝管空肠吻合术切除胆总管囊肿均取得了良好效果。将再次手术与初次手术的手术时间、失血量及手术结果进行比较后得出结论,除非存在其他避免切除的原因,所有胆总管囊肿均应在首次手术时切除。对于合并远端闭锁及肝管发育不良的胆总管囊肿,推荐行肝门空肠吻合术。