产前诊断胆总管囊肿的临床诊疗进展
The progress in clinical diagnosis and treatment of choledochal cyst diagnosed prenatally
黄挺 1刁美1
作者信息
- 1. 首都儿科研究所附属儿童医院普通外科,北京 100020;北京协和医学院研究生院首都儿科研究所,北京 100005
- 折叠
摘要
胆总管囊肿是儿童发病率较高的先天性胆道畸形,手术是唯一根治的方法.随着产检影像学技术的提高,产前诊断胆总管囊肿逐渐增多,其影像学表现及临床表现复杂多变、实验室检查结果不典型,需出生后进一步手术探查明确诊断.同时,大多数产前诊断胆总管囊肿患儿出生后无症状,随着年龄增长及生后进食,胆道梗阻逐渐加重,术前可发生穿孔、肝纤维化等一系列并发症,其手术干预时机及穿孔后手术方法尚存争议.另外,随着腹腔镜技术的应用、围手术期管理水平的提高以及抗生素的使用与升级,腹腔镜下根治产前诊断胆总管囊肿安全有效.本文从产前诊断胆总管囊肿的临床表现、辅助检查、诊断及鉴别诊断、手术治疗等相关诊疗进展进行综述.
Abstract
Choledochal cyst is a congenital biliary malformation with high incidence in children,and surgery is the only radical treatment.With the improvement of antenatal imaging technology,the prenatal diagnosis of choledochal cyst is gradually increasing.The postpartum clinical features and imaging manifestations of choledochal cyst in prenatal diagnosis are complex and variable,and laboratory test results are atypical,requiring further surgical exploration after birth to confirm the diagnosis.At the same time,most children with prenatally diagnosed choledochal cyst are asymptomatic after birth,and with age and postnatal feeding,biliary obstruction gradually worsens.A series of complications such as perforation and liver fibrosis can occur before surgery,and the timing of surgical intervention and the methods of post-perforation surgery treatment are still controversial.In addition,with the application of laparoscopic technology,the improvement of perioperative management,and the use and upgrading of antibiotics,radical laparoscopic surgery for prenatally diagnosed choledochal cyst is safe and effective.This article reviews the clinical manifestations,auxiliary examinations,diagnosis and differential diagnosis,and surgical treatment of prenatally diagnosed choledochal cysts.
关键词
胆总管囊肿/产前诊断/治疗Key words
Choledochal cyst/Prenatal diagnosis/Treatment引用本文复制引用
基金项目
中国医科院小儿外科微创诊疗创新单元项目(2021RU015)
出版年
2024
国家科技期刊平台
NSTL
万方数据