妊娠期胆总管囊肿的诊治分析.doc

《妊娠期胆总管囊肿的诊治分析.doc》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、妊娠期胆总管囊肿的诊治分析【摘要】目的探讨妊娠期胆总管嚢肿的临床特征、诊断和治疗方案。方法收集自XX年以来收治的3例妊娠期胆总管囊肿的临床资料，进行随访与回顾性分析。结果3例患者均为I型胆总管囊肿，术前均有急性胆管炎发作史，1例患者孕22周因严重的胆管炎经非手术治疗无效而急诊行胆总管T管外引流术，术后出现先兆流产而行引产，于术后3月行囊肿切除胆管空肠Roux-Y吻合术。另2例均发生于妊娠晚期，经非手术治疗控制胆管炎症状后，继续妊娠，于足月剖腹产后第6天及2周行囊肿切除胆管空肠Roux-Y吻合术。3例患者随访

2、至今均情况良好。结论妊娠期胆总管囊肿以B超作为首选检查手段，对于B超无法确诊的患者，可选用MRCP，妊娠期无症状者以随访为主，待分娩后再行胆总管囊肿切除术；对于有症状而经非手术治疗无效者，行胆总管T管外引流术，分娩后再行囊肿切除术。【关键词】胆总管囊肿妊娠外科手术AnalysisofdiagnosisandtreatmentofcongenitalcholedochalcystinpregnancyAbstractsthee1inicalfeaturtmentmethodforcongystinpregna

3、ncies.MObjectiveTodiscuse,diagnosisandtreaenitaicholedochalcethodsThee1inicaltherapytocontrolthtpregnaneyuntilfulectivelyunderwentcx-Ycholangio-jejun4thdayaftercesarearesultsshowedthattlverywelluptonow.Cdataofthreepatients,diagnosedofcongenitalcholedochalc

4、ystinpregnancywerecollectedsinceXX.Fo1low-upandretrospectiveanalysiswerecarriedout.ResultsThreepatientswerealldiagnosedastypeIthacutecholangitissgivenaT-tubebiliacholedochalcystswi.ThefirstpatientwarydrainageemergentlybecauseoftheseriouscholangEitisinher22

5、weekspregnaneyafterconservativetreatment.Postoperatively，shewasdiagnosedofthreatenedabortionandthenwasgiveninducedlabor.Threemonthslater,thepatientacceptedcy-Ycholangio-jejunostresectionandRouxstomy.Theothertwopatientsbothdiagnosedofthesamediseaseinlatepre

6、gnantstage(34weeksand36weeks,respectively)acceptedconservativeecholangitisandkeplterm.ThentheyrespystresectionandRouostomyonthe6thandlnsection.Follow-叩hreepatientswerealone1usionBuitrasoundshouldbeconsideredastherecommendedtestindiagnosingcholedochalcysts.

7、Iftheresultofultrasoundtestcantconfirmthedisease,MRCPshouldbechosen.Forthepatientswithoutanysymptoms，followupshouldbegivenandtheoperationofcystresectionandRoux-Ycystojejunostomyshouldbedoneafterdelivery.Forthepatientswhoseconditiondidnotimproveduringconser

8、vativetherapy，Ttubebiliarydrainageshouldbechosenfirstly，butcystresectioncombinedwithRoux-Ycholangio-jejunostomyshouldbedoneafterdelivery.Keywordscholedochalcyst；pregnancy；surgery近年来发生于妊娠或产后期间的胆总管囊肿的个案报道逐渐增多[1