综述

先天性胆管扩张症分型及外科治疗

展开
  • 中国医科大学附属盛京医院第二普通外科 胆道外科,辽宁 沈阳 110004

收稿日期: 2023-01-19

  网络出版日期: 2023-06-06

Classification and surgical treatment of congential biliary dilatation

Expand
  • The 2nd Department of General Surgery, Department of Biliary Surgery, Shengjing Hospital of China Medical University, Liaoning Shenyang 110004, China

Received date: 2023-01-19

  Online published: 2023-06-06

摘要

先天性胆管扩张症(congential biliary dilitation,CBD)是临床上较少见的胆道疾病。熟练掌握CBD的临床分型及其疾病特征是精准治疗的关键。对于成年CBD病人,外科手术治疗为首选,包括传统外科手术。对术中胆道重建策略尚存争议。本文综述CBD的诊疗进展。

本文引用格式

王溍, 吴硕东 . 先天性胆管扩张症分型及外科治疗[J]. 外科理论与实践, 2023 , 28(02) : 166 -170 . DOI: 10.16139/j.1007-9610.2023.02.15

Abstract

Congential biliary dilitation (CBD) is rare biliary tract disease in clinic. Clinical classification and disease characteristics of CBD is the key of accurate treatment. Surgical treatment was regarded as the first choice for adult patients with CBD including traditional surgery. There is still a controversy in the strategy of reconstruction of bile duct during operation. In this article the progress in diagnosis and treatment of CBD was reviewed.

参考文献

[1] HAMADA Y, HAMADA H, SHIRAI T, et al. Duodenogastric regurgitation in hepaticoduodenostomy after excision of congenital biliary dilatation(choledochal cyst)[J]. J Pediatr Surg, 2017, 52(10):1621-1624.
[2] LIPSETT P A, PITT H A, COLOMBANI P M, et al. Choledochal cyst disease. A changing pattern of presentation[J]. Ann Surg, 1994, 220(5):644-652.
[3] URIBARRENA AMEZAGA R, RAVENTOS N, FUENTES J, et al. Diagnosis and management of choledochal cysts. A review of 10 new cases[J]. Rev Esp Enferm Dig, 2008, 100(2):71-75.
[4] EDIL B H, CAMERON J L, REDDY S, et al. Choledochal cyst disease in children and adults: a 30-year single-institution experience[J]. Am Coll Surg, 2008, 206(5):1000-1005.
[5] ALY M Y F, MORI Y, MIYASAKA Y, et al. Laparoscopic surgery for congenital biliary dilatation: a single-institution experience[J]. Surg Today, 2018, 48(1):44-50.
[6] 中华医学会外科学分会胆道外科学组. 胆管扩张症诊断与治疗指南(2017版)[J]. 中华消化外科杂志, 2017, 16(8):767-774.
[6] Branch of Biliary Surgery, Chinese Society of Surgery, Chinese Medical Association. Guideline for the diagnosis and treatment for biliary dilatation (2017 edition)[J]. Chin J Dig Surg, 2017, 16(8):767-774.
[7] SARRIS G E, TSANG D. Choledochocele: case report, literature review, and a proposed classification[J]. Surgery, 1989, 105(3):408-414.
[8] 蒲思宇, 靳曙光, 严律南, 等. 先天性胆管扩张症新分型——CBD华西分型法[J]. 中国普外基础与临床杂志, 2023, 30(1):23-29.
[8] PU S Y, JIN S G, YAN L N, et al. A new classification of congenital biliary dilatation—HUAXI CBD classification[J]. Chin J Bases Clin Gen Surg, 2023, 30(1):23-29.
[9] 王辉, 王坚. 110例成人型胆管扩张症的临床诊治分析[J]. 腹部外科, 2018, 31(5):311-316.
[9] WANG H, WANG J. Clinical diagnosis and treatment of 110 adults with biliary dilatation[J]. J Abdom Surg, 2018, 31(5):311-316.
[10] TASHIRO S, IMAIZUMI T, OHKAWA H, et al. Pancrea-ticobiliary maljunction: retrospective and nationwide survey in Japan[J]. J Hepatobiliary Pancreat Surg, 2003, 10(5):345-351.
[11] SINGHAM J, SCHAEFFER D, YOSHIDA E, et al. Choledochal cysts: analysis of disease pattern and optimal treatment in adult and paediatric patients[J]. HPB (Oxford), 2007, 9(5):383-387.
[12] MORINE Y, SHIMADA M, TAKAMATSU H, et al. Clinical features of pancreaticobiliary maljunction: update analysis of 2nd Japan-nationwide survey[J]. J Hepatobi-liary Pancreat Sci, 2013, 20(5):472-480.
[13] TODANI T, WATANABLE Y, TOKI A, et al. Carcinoma relate to choledochal cysts with internal drainage operation[J]. Surg Gynecol Obstet, 1987, 164(1):61-64.
[14] XIA H T, DONG J H, YANG T, et al. Selection of the surgical approach for reoperation of adult choledochal cysts[J]. J Gastrointest Surg, 2015, 19(2):290-297.
[15] 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.
[16] TAO K S, LU Y G, WANG T, et al. Procedures for congenital choledochal cysts and curative effect analysis in adults[J]. Hepatobiliary Pancreat Dis Int, 2002, 1(3):442-445.
[17] 杨永光, 刘丽娟, 鲁才杰, 等. 成人先天性胆管扩张症33例诊治体会[J]. 岭南现代临床外科, 2017, 17(3):271-274.
[17] YANG Y G, LIU L J, LU C J, et al. The experience of diagnosis and treatment of congenital cholangiectasis in adults:a report of 33 cases[J]. Lingnan Mod Clin Surg, 2017, 17(3):271-274.
[18] SOARES K C, KIM Y, SPOLVERATO G, et al. Presentation and clinical outcomes of choledochal cysts in children and adults: a multi-institutional analysis[J]. JAMA Surg, 2015, 150(6):577-584.
[19] XIA H T, DONG J H, YANG T, et al. Extrahepatic cyst excision and partial hepatectomy for Todani type Ⅳ-A cysts[J]. Dig Liver Dis, 2014, 46(11):1025-1030.
[20] MACHADO N O, CHOPRA P J, Al-ZADJALI A, et al. Choledochal cyst in adults: etiopathogenesis, presentation, management, and outcome-case series and review[J]. Gastroenterol Res Pract, 2015, 2015:602591.
[21] GORDON S R, LEVENICK J M, RATH D L, et al. Case of a closed choledochocele with biliary and pancreatic drainage via the accessory duct causing acute pancreatitis[J]. Dig Endosc, 2009, 21(2):106-108.
[22] HIRATSUKA J, AKIBA T, KUCERA KESTIES M, et al. Balloon-catheter-assisted endoscopic snare resection for choledochocele using a single-channel duodenoscope[J]. Endoscopy, 2012, 44 Suppl 2 UCTN:E6-E7.
[23] TEKIN F, OZUTEMIZ O, ERSOZ G, et al. A new endoscopic treatment method for a symptomatic duodenal duplication cyst[J]. Endoscopy, 2009, 41 Suppl 2:E32-E33.
[24] MABRUT J Y, 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.
[25] FARELLO G A, CEROFOLINI A, REBONATO M, et al. Congenital choledochal cyst: video-guided laparoscopic treatment[J]. Surg Laparosc Endosc, 1995, 5(5):354-358.
[26] SHIMOTAKAHARA A, YAMATAKA A, YANAI T, et al. Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy for biliary reconstruction during the surgical treatment of choledochal cyst: which is better?[J]. Pediatr Surg Int, 2005, 21(1):5-7.
[27] TODANI T, WATANABE Y, URUSHIHARA N, et al. Biliary complications after excisional procedure for choledochal cyst[J]. J Pediatr Surg, 1995, 30(3):478-481.
[28] ROSE J B, BILDERBACK P, RAPHAELI T, et al. Use the duodenum, it's right there: a retrospective cohort study comparing biliary reconstruction using either the jejunum or the duodenum[J]. JAMA Surg, 2013, 148(9):860-865.
[29] FELDER S I, MENON V G, NISSEN N N, et al. Hepaticojejunostomy using short-limb Roux-en-Y reconstruction[J]. JAMA Surg, 2013, 148(3):253-257.
[30] DIAO M, LI L, ZHANG J Z, et al. A shorter loop in Roux-Y hepatojejunostomy reconstruction for choledochal cysts is equally effective: preliminary results of a prospective randomized study[J]. J Pediatr Surg, 2010, 45(4):845-847.
[31] MUKHOPADHYAY B, SHUKLA R M, MUKHOPADHYAY M, et al. Choledochal cyst: a review of 79 cases and the role of hepaticodochoduodenostomy[J]. J Indian Assoc Pediatr Surg, 2011, 16(2):54-57.
[32] GUZMAN J P S, RESURRECCION Ⅲ L L, SUNTAY M L R,et al. Comparison between hepaticojejunostomy and hepaticoduodenostomy after excision of choledochal cyst in children: a cohort study[J]. World J Pediatr Surg, 2019, 2(2):5.
[33] AI C, WU Y, XIE X, et al. Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy for biliary reconstruction after resection of congenital biliary dilatation: a syste-maic review and meta-analysis[J]. Surg Today, 2023, 53(1):1-11.
[34] LIEM N T, AGRAWAL V, AISON D S. Laparoscopic management of choledochal cyst in children: lessons learnt from low-middle income countries[J]. J Minim Access Surg, 2021, 17(3):279-286.
[35] ARAFA A, RAGAB M, ELTAGY G H. Laparoscopic hepaticoduodenostomy for choledochal cysts in children <1 year[J]. Afr J Paediatr Surg, 2022, 19(1):36-39.
[36] QIAO G, LI L, LI S, et al. Laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts in China: a multicenter study[J]. Surg Endosc, 2015, 29(1):140-144.
[37] YAMATAKA A, LANE G J, CAZARES J. Laparoscopic surgery for biliary atresia and choledochal cyst[J]. Semin Pediatr Surg, 2012, 21(3):201-210.
[38] NGUYEN THANH L, HIEN P D, DUNG LE A, et al. Laparoscopic repair for choledochal cyst: lessons learned from 190 cases[J]. J Pediatr Surg, 2010, 45(3):540-544.
[39] ZHEN C, XIA Z, LONG L, et al. Laparoscopic excision versus open excision for the treatment of choledochal cysts: a systematic review and meta-analysis[J]. Int Surg, 2015, 100(1):115-122.
[40] DUAN X, MAO X, JIANG B, et al. Totally laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for choledochal cyst in adults: a single-institute experience of 5 years[J]. Surg Laparosc Endosc Percutan Tech, 2015, 25:e65-e68.
[41] ALIZAI N K, DAWRANT M J, NAJMALDIN A S. Robot-assisted resection of choledochal cysts and hepaticojejunostomy in children[J]. Pediatr Surg Int, 2014, 30(3):291-294.
[42] ZHANG K, ZHAO D, XIE X, et al. Laparoscopic surgery versus robot-assisted surgery for choledochal cyst excision: a systematic review and meta-analysis[J]. Front Pediatr, 2022, 10:987789.
[43] WANG X Q, XU S J, WANG Z, et al. Robotic-assisted surgery for pediatric choledochal cyst: case report and lite-rature review[J]. World J Clin Cases, 2018, 6(7):143-149.
文章导航

/