中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

累及肝内胆管的先天性胆管扩张症:外科治疗的进展、难点与争议

杨世忠 项灿宏

引用本文:
Citation:

累及肝内胆管的先天性胆管扩张症:外科治疗的进展、难点与争议

DOI: 10.3969/j.issn.1001-5256.2017.02.011
详细信息
  • 中图分类号: R657.44

Surgical treatment of congenital bile duct dilatation with involvement of the intrahepatic bile duct:advances,difficulties,and controversy

  • 摘要: 先天性胆管扩张症可发生在胆道树的任何部位,其中累及肝内胆管的病变在诊治方面最具挑战性。外科手术在先天性胆管扩张症的治疗中占据主导地位,手术目的在于缓解症状、防止病情进展和恶性转化。手术的原则是彻底去除病灶,建立通畅的胆汁引流通道。针对肝内胆管受累的先天性胆管扩张症,手术方式主要是肝切除,弥漫性病变可采取肝移植。因此,采取积极肝切除和早期干预的策略将使患者获益最大。

     

  • [1]HAMADA Y,ANDO H,KAMISAWA T,et al.Diagnostic criteria for congenital biliary dilatation 2015[J].J Hepatobiliary Pancreat Sci,2016,23(6):342-346.
    [2]SASTRY AV,ABBADESSA B,WAYNE MG,et al.What is the incidence of biliary carcinoma in choledochal cysts,when do they develop,and how should it affect management?[J].World JSurg,2015,39(2):487-492.
    [3]TODANI T,WATANABE Y,NARUSUE M,et al.Congenital bile duct cysts:classification,operative procedures,and review of 37cases including cancer arising from choledochal cyst[J].Am JSurg,1977,134(2):263-269.
    [4] DONG JH,ZHENG XH,XIA HT,et al.Cystic dilation of bile duct:new clinical classification and treatment strategy[J].Chin JDig Surg,2013,12(5):370-377.(in Chinese)董家鸿,郑秀海,夏红天,等.胆管囊状扩张症:新的分型与治疗策略[J].中华消化外科杂志,2013,12(5):370-377.
    [5]DONG JH,YANG SZ,XIA HT,et al.Aggressive hepatectomy for the curative treatment of bilobar involvement of typeⅣ-A bile duct cyst[J].Ann Surg,2013,258(1):122-128.
    [6]VISSER BC,SUH I,WAY LW,et al.Congenital choledochal cysts in adults[J].Arch Surg,2004,139(8):855-860;discussion 860-862.
    [7]HILL R,PARSONS C,FARRANT P,et al.Intrahepatic duct dilatation in type 4 choledochal malformation:pressure-related,postoperative resolution[J].J Pediatr Surg,2011,46(2):299-303.
    [8]TODANI T,WATANABE Y,TOKI A,et al.Classification of congenital biliary cystic disease:special reference to type Ic andⅣAcysts with primary ductal stricture[J].J Hepatobiliary Pancreat Surg,2003,10(5):340-344.
    [9]CHO MJ,HWANG S,LEE YJ,et al.Surgical experience of 204cases of adult choledochal cyst disease over 14 years[J].World JSurg,2011,35(5):1094-1102.
    [10]SOARES KC,ARNAOUTAKIS DJ,KAMEL I,et al.Choledochal cysts:presentation,clinical differentiation,and management[J].JAm Coll Surg,2014,219(6):1167-1180.
    [11]MABRUT JY,KIANMANESH R,NUZZO G,et al.Surgical management of congenital intrahepatic bile duct dilatation,Caroli's disease and syndrome:long-term results of the French Association of Surgery Multicenter Study[J].Ann Surg,2013,258(5):713-721.
    [12]WANG YB,DONG JH,CHEN JY,et al.Segmental hepatectomy for diffuse Caroli disease[J].Chin J Dig Surg,2009,8(3):234-235.(in Chinese)王彦斌,董家鸿,陈继业,等.弥漫型Caroli病行肝段切除[J].中华消化外科杂志,2009,8(3):234-235.
    [13]MABRUT JY,PARTENSKY C,JAECK D,et al.Congenital intrahepatic bile duct dilatation is a potentially curable disease:longterm results of a multi-institutional study[J].Ann Surg,2007,246(2):236-245.
    [14]DONG J,YANG S,ZENG J,et al.Precision in liver surgery[J].Semin Liver Dis,2013,33(3):189-203.
    [15]MABRUT JY,PARTENSKY C,GOUILLAT C,et al.Cystic involvement of the roof of the main biliary convergence in adult patients with congenital bile duct cysts:a difficult surgical challenge[J].Surgery,2007,141(2):187-195.
    [16]OHASHI T,WAKAI T,KUBOTA M,al.Risk of subsequent biliary malignance in patients undergoing cyst excision for congenital choledochal cysts[J].J Gastroenterol Hepatol,2013,28(2):243-247.
    [17]LIANG B,HUANG XQ,DONG JH.Controversy and progress in surgical treatment of congenital choledochal cyst[J].J Chin PLAPostgrad Med School,2011,32(11):1176-1178.(in Chinese)梁斌,黄晓强,董家鸿.先天性胆管囊状扩张症外科治疗的争议与进展[J].军医进修学院学报,2011,32(11):1176-1178.
    [18]SREIDE K,SREIDE JA.Bile duct cyst as precursor to biliary tract cancer[J].Ann Surg Oncol,2007,14(3):1200-1211.
    [19]ZHENG X,GU W,XIA H,et al.Surgical treatment of type IV-Acholedochal cyst in a single institution:children vs.adults[J].JPediatr Surg,2013,48(10):2061-2066.
    [20]CONGO K,LOPES MF,OLIVEIRA PH,et al.Outcomes of choledochal cysts with or without intrahepatic involvement in children after extrahepatic cyst excision and Roux-en-Y hepaticojejunostomy[J].Ann Hepatol,2012,11(4):536-543.
    [21]KOSHINAGA T,INOUE M,OHASHI K,et al.Persistent biliary dilatation and stenosis in postoperative congenital choledochal cyst[J].J Hepatobiliary Pancreat Sci,2011,18(1):47-52.
    [22]OUAISSI M,KIANMANESH R,RAGOT E,et al.Congenital bile duct cyst(BDC)is a more indolent disease in children compared to adults,except for Todani typeⅣ-A BDC:results of the European multicenter study of the French Surgical Association[J].HPB(Oxford),2016,18(6):529-539.
    [23]DUTTA HK.Hepatic lobectomy and mucosectomy of intrahepatic cyst for typeⅣ-A choledochal cyst[J].J Pediatr Surg,2012,47(11):2146-2150.
    [24]KO JW,CHOI SH,KWON SW,et al.Robot-assisted hepatectomy and complete excision of the extrahepatic bile duct for type IV-A choledochalcysts[J].Surg Endosc,2016,30(12):5626-5627.
    [25]KIM JH,CHOI TY,HAN JH,et al.Risk factors of postoperative anastomotic stricture after excision of choledochal cysts with hepaticojejunostomy[J].J Gastrointest Surg,2008,12(5):822-828.
    [26]KATABI N,PILLARISETTY VG,DeM ATTEO R,et al.Choledochal cysts:a clinicopathologic study of 36 cases with emphasis on the morphologic and the immunohistochemical features of premalignant and malignant alterations[J].Human Pathol,2014,45(10):2107-2114.
    [27]WATANABE Y,TOKI A,TODANI T.Bile duct cancer developed after cyst excision for choledochal cyst[J].J Hepatobiliary Pancreat Surg,1999,6(3):207-212.
    [28]JANG MH,LEE YJ,KIM H.Intrahepatic cholangiocarcinoma arising in Caroli's disease[J].Clin Mol Hepatol,2014,20(4):402-405.
  • 加载中
计量
  • 文章访问数:  343
  • HTML全文浏览量:  16
  • PDF下载量:  255
  • 被引次数: 0
出版历程
  • 收稿日期:  2016-11-29
  • 出版日期:  2017-02-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回