中国实用外科杂志

中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (03): 191-192.

• 专题笔谈 • 上一篇    下一篇

先天性胆管扩张症分型与术式选择

周宁新，谢    于   

  1. 第二炮兵总医院肝胆外科研究所，北京100088
  • 出版日期:2012-03-01 发布日期:2012-02-24

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

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摘要：

先天性胆管扩张症以Todani分型分为I～V型，且已为广大外科医师所接受。手术方式上对于I、Ⅱ和Ⅳ型大多选择胆总管囊肿的全切除+肝总管空肠Roux-en-Y吻合；基本废弃了内引流术式；外引流作为急诊时的过渡性手术。对于Caroli病则根据病变的部位而有所不同，单发局限型行肝叶或肝段切除术；对于肝内多发病灶或弥漫型，治疗上主要是针对反复发作的胆管炎及肝内胆管结石等并发症问题的处理，必要时进行肝脏移植；对于中央型的，尽量切除囊壁，选择最低位行空肠Roux-en-Y吻合。治疗上不可一概而论，对各种术式应有清晰的认识。

关键词: 先天性胆管扩张症, 分型

Abstract:

Classification and surgical managements of congenital biliary dilatation        ZHOU Ning-xin, XIE Yu. Research Institute of Hepatobiliary Surgery, the Second Artillery General Hospital，Beijing100088，China
Corresponding author: XIE Yu, E-mail: suzhouxieyu@163.com
Abstract    Todani has classified congenital biliary dilatation I-V type. To I, Ⅱ and IV type, choledochal cyst should be resected totally plus Roux-en-Y hepaticojejunostomy. To Caroli disease, lobe or segmentectomy may be choiced if the lesion is limited. To those frequently-occuring disease, it should mainly treat the complications such as cholangitis and intrahepatic bile duct stones, and liver transplatation maybe choiced if necessary. To central type, capsule wall should be resected as far as possible. The managements should be diversified and the surgical indications should be kept in mind. 

Key words: congenital biliary dilatation, type