ABSTRACT
Objective To discuss the method of the surgical treatment for retained and regenerate hepaticolithiasis, and to improve the theraputic level. Methods In recent 5 years,in our hospital,136 cases of retained and regenerate hepaticolithiasis were treated by combination of hepatolobectomy with other operation, and these cases were analyzed retrospectivly. Results One patient died after operation (0. 7%),8 patients had other complications including: biliary fistuta(6 cases, 4.4%), subphrenic abscess (2 cases,1.5%). All cases were visited for 2.5 - 8.3 years, 115 (84.6%) cases had not any symptom, 6 (4.4%)cases had infection of biliary tract, 6(4.4%) cases had retained calculus, 9(6.6%) cases recurred calculus 2 -5 years after operation. Conclusion Retained and regenerate hepaticolithiasis should be treated by combination of hepatolobectomy with other operation and fiber choledochoscope and B ultrasound of operation, which can increase therapeutic effect.
ABSTRACT
Objective To discuss the relationship of congenital choledochus cyst(CCC)with occurrence of pancreatitis in adults and methods of surgical treatment.Methods The clinical data of 17 adult patients with congenital choledochus cyst who underwent surgical treatment from 1997-2005 were analyzed retrospectively.Results Clinical diagnosis was made mainly by B-ultrasound,MRCP,intraoperative cholangiography,ERCP and CT scans.Among 17 cases,10 cases were congenital choledochus cyst typeⅠ,4 cases type Ⅱ,1 case type Ⅲ,1 case type Ⅳ and 1 case type Ⅴ;and associated with cholelithiasis in 14 cases(bile pigment stone in 11cases,cholesterol calculus 3cases),chronic cholecytitis 5 cases,polypoid lesions of gallbladder 1 case,anomalous pancreaticobiliary junction(APBJ)10 cases,and pancreatitis 10 cases.Resection of extrahepatic cyst with Roux-y hepaticojejunostimy was performed in 15 cases,preserving pylorus pancreatoduodinectomy in 1 case,and cholecystectomy and T tube drainage in 1 case.Excellent and good results were achieved on follow-up in 14 out of the 17 CCC cases undergoing surgical treatment,while pancreatitis occurred in 2 cases and unexpected death in 1 case.Conclusions Pancreatitis is apt to occurr in CCC with APBJ and bile pigment stone in choledochus.The incidence of pancreatitis in CCC and APBJ(P-B)can be decreased by resection of extrahepatic cyst and Roux-en-Y hepaticojejunostimy and cholecystectomy.