发育医学电子杂志 2022, Vol. 10 Issue (1): 75-80 DOI: 10.3969/j.issn.2095-5340.2022.01.014
结构畸形
综述
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小儿胆总管囊肿的手术治疗及并发症 处理
杜航 张奥丹 杨书龙 张泽楠 李昭铸
哈尔滨医科大学附属第二医院 小儿外 科 150000
Surgical treatment and complications of choledochal cyst in children
Du Hang, Zhang Aodan, Yang Shulong, et al
摘要 胆总管囊肿(choledochal cyst,CC),亦被称作 胆管扩张症,可以在患儿母亲产检时发现。据相 关报道,在日本每1 000 人就有1 人患病,远远高 于西方人群[1] 。病患中女性占多数,男女比例为 1 ∶ 3 ~ 1 ∶ 4。30% ~ 60% 的患者在10 岁之前 就出现临床症状[2] 。CC 的长时间存在会引起胆道 一系列的炎症反应,由于囊肿壁反复受到炎症的刺 激,有癌变的风险,所以胆总管囊肿切除、胆道重建 手术成为治疗的金标准[3] 。对于手术时机的选择, 并没有成文的规定。而其治疗方式经过囊肿内引 流、囊肿外引流的发展,现多已形成囊肿切除、胆肠 吻合的标准术式。随着微创技术的到来,腹腔镜手 术为众多外科医生所追捧,从普通腔镜到单孔腔镜 手术,再到达芬奇机器人手术等不断用于CC 的手 术中。由于患儿自身体质、疾病的严重程度以及手 术操作者熟练程度的差异,可能会出现不同的并发 症,而对各种并发症的处理也各有差异。本文主要 对CC 手术时机的选择、腹腔镜手术的发展、常见并 发症的出现与处理进行综述。
关键词:
胆总管囊肿
婴幼儿
腹膜炎
收稿日期: 2020-07-13
发布日期: 2022-01-28
基金资助: 国家自然科学基金资助项目(81871837)
通讯作者:
李昭铸
E-mail: zhaozhu247@163.com
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