總胆管囊腫一個案分析與文獻回顧

Choledochal Cyst-Cases Analysis and Literatures Review

蔡長晃(Chang-Huang Tsai)

《中華放射線醫學雜誌》 7卷3期 (1982/09) Pp. 210-219

摘要

長庚醫院自從民國65年12月成立至70年12月止的五年中，共有24個總瞻管囊腫(choledochal cyst)的病例，其中23個接受開刀治療。年齡以10歲以下居多（佔50%），而性別方面以女性佔大部分(71%)。臨床上的表現有黃疸、腹痛、腹腫塊等現象。X光方面的診斷方法有上胃腸道攝彰，膽道與斷層攝影，內視鏡逆行性瞻道胰管攝影(ERCP)等；其中ERCP的X光片將可印證一些文獻上所報導的致病原因。

並列摘要

In the past 5 years, there were 24 cases of choledochal cyst in Chang Gung Memorial Hospital, 23 cases were surgically and pathologically proved, and only one was proved by ultrasound. The clinical symptoms and signs, laboratory data and radiological findings were reviewed, and were also studied carefully to confirm the etiology and pathogenesis of choledochal cyst reported in many series.
According to the age and sex incidences, about 50% of the patients were under 10 years of age, and 71% of the patients were female.
The classical triad of choledochal cyst was noted to be 25% in our series. The laboratory data showed obstructive jaundice and evidence of infection. Many cases were associated with pancreatitis. The operation findings revealed chronic cholangitis, chronic cholecystitis, dilatation of the biliary tree and stenosis at common excretory duct or at the lower portion of the common bile duct.
For diagnosis of the choledochal cyst, Many procedures can be applied, but ERCP is most useful for detailed demonstration of the anomalous junction of the pancreaticobiliary ductal system. The embryological failure of normal separation of common bile duct and common pancreatic duct makes a long common excretory duct and causes serial pathological changes of the common bile duct. This is the current concept of pathogenesis of choledochal cyst.