中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (03): 181-182.

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先天性胆管扩张症诊治中值得关注的问题

梁力建   

  1. 中山大学附属第一医院肝胆外科,广东广州510080
  • 出版日期:2012-03-01 发布日期:2012-02-24

  • Online:2012-03-01 Published:2012-02-24

摘要:

先天性胆管扩张症(congenital biliary dilatation,CBD)常并发结石、胆管炎,具有较高的癌变率,因此需要特别关注。目前,对CBD的病因仍未明确,涉及到胆胰结合部畸形、感染、神经、基因及遗传等因素。CBD的临床分型在Todani分型的基础上仍有不断的变更和补充。治疗的关键是完全切除囊肿,尤其是Ⅰ型和Ⅳ型的囊肿,但对ⅣA型的治疗仍有不同意见。在手术治疗中,有时仍会遇到各种各样需要解决的困难。

关键词: 先天性胆管扩张症, 分型

Abstract:

Some questions of the diagnosis and management in patients with congenital biliary dilatation        LIANG Li-jian. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080,China
Abstract    More attention should be paid on the treatment of congenital biliary dilatation (CBD), as lithiasis, cholangitis and high canceration rate are common concurrence in patients suffering from CBD. To date, the definite etiology of CBD remains obscure and has not been identified, which is complicated with anomalous pancreaticobiliary ductal juction, infection, neuropathy, genetic or inheritance factors. Base on the Todani staging system, clinical staging of CBD is far from reaching a consensus and which still need to be improved. Complete resection of the cyst is the key for the treatment of CBD, especially for the Todani Type Ⅰ and Type Ⅳ CBD. Although there are still some discrepancies in the treatment of Type ⅣA CBD and challenges in some surgical operations.

Key words: congenital biliary dilatation, classification