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胆管扩张症的研究进展
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Abstract:
胆管扩张症(biliary dilatation, BD)是临床较少见的一种原发的胆道畸形病变。BD虽然为良性疾病,但如未能及时治疗可引起多种肝胆胰疾病,包括胰腺炎、胆道结石、自发性囊肿破裂等。此外,值得关注的是BD患者的胆道癌变率会随着年龄的增长而升高,未行手术治疗的BD有高达30%的癌变率。因此一旦诊断为BD应及时行手术治疗。自1723年Voter首次报道此病以来,随着腹部超声和CT、MRCP等影像学检查的普及,BD的诊断率有逐年明显升高趋势。
Biliary dilatation (BD) is a rare type of primary bile duct deformity. Although BD is a benign disease, if not treated in time, it can cause a variety of hepatobiliary and pancreatic diseases, including pan-creatitis, biliary stones, spontaneous cyst rupture and so on. In addition, it is worth noting that the biliary cancer rate of BD patients will increase with age, and the cancer rate of BD patients without surgical treatment is as high as 30%. Therefore, once BD is diagnosed, timely surgical treatment should be performed. Since this disease was first reported by Voter in 1723, with the popularization of abdominal ultrasound, CT, MRCP and other imaging examinations, the diagnostic rate of BD has increased significantly year by year.
[1] | 董家鸿, 霍枫, 季茹. 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. |
[2] | Ronnekleiv-Kelly, S.M., Soares, K.C., Ejaz, A. and Pawlik, M. (2016) Management of Choledochal Cysts. Current Opinion in Gastroenterology, 32, 225-231. https://doi.org/10.1097/MOG.0000000000000256 |
[3] | Jab?ońska, B. (2012) Biliary Cysts: Etiology, Diagnosis and Management. World Journal of Gastroenterology, 18, 4801-4810. https://doi.org/10.3748/wjg.v18.i35.4801 |
[4] | Wiseman, K., Buczkowski, A.K., Chung, S.W., et al. (2005) Epide-miology, Presentation, Diagnosis, and Outcomes of Choledochal Cysts in Adults in an Urban Environment. The Ameri-can Journal of Surgery, 189, 527-531.
https://doi.org/10.1016/j.amjsurg.2005.01.025 |
[5] | Woon, C.Y., Tan, Y.M., Oei, C.L., et al. (2006) Adult Chole-dochal Cysts: An Audit of Surgical Management. ANZ Journal of Surgery, 76, 981-986. https://doi.org/10.1111/j.1445-2197.2006.03915.x |
[6] | 申铭, 张俊, 秦仁义. 胰胆管合流异常与先天性胆管扩张症[J]. 中国实用外科杂志, 2012, 32(3): 244-246. |
[7] | Sugiyama, M. and Atomi, Y. (1997) Endoscopic Ultraso-nography for Diagnosing Anomalous Pancreaticobiliary Junction. Gastrointestinal Endoscopy, 45, 261-267. https://doi.org/10.1016/S0016-5107(97)70268-2 |
[8] | Tashiro, S., Imaizumi, T., Ohkawa, H., et al. (2003) Pancre-aticobiliary Maljunction: Retrospective and Nationwide Survey in Japan. Journal of Hepato-Biliary-Pancreatic Surgery, 10, 345-351.
https://doi.org/10.1007/s00534-002-0741-7 |
[9] | Csendes, A., Kruse, A., Funch-Jensen, P., et al. (1979) Pressure Measurements in the Biliary and Pancreatic Duct Systems in Controls and in Patients with Gallstones, Previous Chole-cystectomy, or Common Bile Duct Stones. Gastroenterology, 77, 1203-1210. https://doi.org/10.1016/0016-5085(79)90158-6 |
[10] | Kamisawa, T., Ando, H., Suyama, M., et al. (2012) Japanese Clinical Practice Guidelines for Pancreaticobiliary Maljunction. Journal of Gastroenterology, 47, 731-759. https://doi.org/10.1007/s00535-012-0611-2 |
[11] | Kamisawa, T., Takuma, K., Anjiki, H., et al. (2009) Pancreati-cobiliary Maljunction. Clinical Gastroenterology and Hepatology, 7, S84-S88. https://doi.org/10.1016/j.cgh.2009.08.024 |
[12] | Friedmacher, F., Ford, K.E. and Davenport, M. (2019) Choledochal Malformations: Global Research, Scientific Advances and Key Controversies. Pediatric Surgery International, 35, 273-282.
https://doi.org/10.1007/s00383-018-4392-4 |
[13] | Soares, K.C., Arnaoutakis, D.J., Kamel, I., et al. (2014) Chole-dochal Cysts: Presentation, Clinical Differentiation, and Management. Journal of the American College of Surgeons, 219, 1167-1180.
https://doi.org/10.1016/j.jamcollsurg.2014.04.023 |
[14] | Davenport, M. and Basu, R. (2005) Under Pressure: Cho-ledochal Malformation Manometry. Journal of Pediatric Surgery, 40, 331-335. https://doi.org/10.1016/j.jpedsurg.2004.10.015 |
[15] | Tsang, T.M., Tam, P.K. and Chamberlain, P. (1994) Oblitera-tion of the Distal Bile Duct in the Development of Congenital Choledochal Cyst. Journal of Pediatric Surgery, 29, 1582-1583. https://doi.org/10.1016/0022-3468(94)90224-0 |
[16] | Spitz, L. (1977) Experimental Production of Cyst-ic Dilatation of the Common Bile Duct in Neonatal Lambs. Journal of Pediatric Surgery, 12, 39-42. https://doi.org/10.1016/0022-3468(77)90293-7 |
[17] | Jona, J.Z., Babbitt, D.P., Starshak, R.J., LaPorta, A.J., Glick-lich, M. and Cohen, R.D. (1979) Anatomic Observations and Etiologic and Surgical Considerations in Choledochal Cyst. Journal of Pediatric Surgery, 14, 315-320.
https://doi.org/10.1016/S0022-3468(79)80490-X |
[18] | Murphy, A.J., Axt, J.R. and Lovvorn III, H.N. (2012) As-sociations between Pediatric Choledochal Cysts, Biliary Atresia, and Congenital Cardiac Anomalies. Journal of Surgical Research, 177, e59-e63.
https://doi.org/10.1016/j.jss.2012.04.018 |
[19] | Lee, H.K., Park, S.J., Yi, B.H., et al. (2009) Imaging Features of Adult Choledochal Cysts: A Pictorial Review. Korean Journal of Radiology, 10, 71-80. https://doi.org/10.3348/kjr.2009.10.1.71 |
[20] | Hill, R., Parsons, C., Farrant, P., Sellars, M. and Davenport, M. (2011) Intrahepatic Duct Dilatation in Type 4 Choledochal Malformation: Pressure-Related, Postoperative Resolution. Journal of Pediatric Surgery, 46, 299-303.
https://doi.org/10.1016/j.jpedsurg.2010.11.008 |
[21] | Alonso-Lej, F., Rever Jr., W.B. and Pessagno, D.J. (1959) Congenital Choledochal Cyst, with a Report of 2, and an Analysis of 94, Cases. International Abstracts of Surgery, 108, 1-30. |
[22] | Visser, B.C., Suh, I., Way, L.W., et al. (2004) Congenital Choledochal Cysts in Adults. Archives of Surgery, 139, 855-862. https://doi.org/10.1001/archsurg.139.8.855 |
[23] | 李斌, 邱智泉, 姜小清. 先天性胆管囊肿“三类五型”分型系统及手术治疗要点[J]. 中华肝脏外科手术学电子杂志, 2021, 10(5): 442-445. |
[24] | 刁美, 林海伟, 明安晓, 等. 先天性胆管扩张症的病因病理及分型研究[J]. 中华小儿外科杂志, 2012, 33(4): 249-253. |
[25] | Todani, T., Watanabe, Y., Toki, A. and Morotomi, Y. (2003) Classification of Congenital Biliary Cystic Disease: Special Reference to Type Ic and IVA Cysts with Primary Ductal Stricture. Journal of Hepato-Biliary-Pancreatic Surgery, 10, 340-344. https://doi.org/10.1007/s00534-002-0733-7 |
[26] | S?reide, K. and S?reide, J.A. (2007) Bile Duct Cyst as Precursor to Biliary Tract Cancer. Annals of Surgical Oncology, 14, 1200-1211. https://doi.org/10.1245/s10434-006-9294-3 |
[27] | Shah, O.J., Shera, A.H., Zargar, S.A., et al. (2009) Choledochal Cysts in Children and Adults with Contrasting Profiles: 11-Year Experience at a Tertiary Care Center in Kashmir. World Journal of Surgery, 33, 2403-2411.
https://doi.org/10.1007/s00268-009-0184-2 |
[28] | Singham, J., Yoshida, E.M. and Scudamore, C.H. (2009) Chole-dochal Cysts: Part 2 of 3: Diagnosis. Canadian Journal of Surgery, 52, 506-511. |
[29] | Sastry, A.V., Abbadessa, B., Wayne, M.G., Steele, J.G. and Cooperman, A.M. (2015) What Is the Incidence of Biliary Carcinoma in Choledochal Cysts, When Do They Develop, and How Should It Affect Management? World Journal of Surgery, 39, 487-492. https://doi.org/10.1007/s00268-014-2831-5 |
[30] | Bhavsar, M.S., Vora, H.B. and Giriyappa, V.H. (2012) Chole-dochal Cysts: A Review of Literature. Saudi Journal of Gastroenterology, 18, 230-236. https://doi.org/10.4103/1319-3767.98425 |
[31] | Singham, J., Schaeffer, D., Yoshida, E. and Scudamore, C. (2007) Choledochal Cysts: Analysis of Disease Pattern and Optimal Treatment in Adult and Paediatric Patients. HPB (Oxford), 9, 383-387.
https://doi.org/10.1080/13651820701646198 |
[32] | Murphy, A.J., Axt, J.R., Crapp, S.J., et al. (2012) Concordance of Imaging Modalities and Cost Minimization in the Diagnosis of Pediatric Choledochal Cysts. Pediatric Surgery Inter-national, 28, 615-621.
https://doi.org/10.1007/s00383-012-3089-3 |
[33] | Haliloglu, M., Akata, D., Gurel, S., ?zmen, M.N. and Akhan, O. (2003) Choledochal Cysts in Children: Evaluation with Three-Dimensional Sonography. Journal of Clinical Ultrasound, 31, 478-480. https://doi.org/10.1002/jcu.10206 |
[34] | Law, R. and Topazian, M. (2014) Diagnosis and Treatment of Choledochoceles. Clinical Gastroenterology and Hepatology, 12, 196-203. https://doi.org/10.1016/j.cgh.2013.04.037 |
[35] | Sacher, V.Y., Davis, J.S., Sleeman, D. and Casillas, J. (2013) Role of Magnetic Resonance Cholangiopancreatography in Diagnosing Choledochal Cysts: Case series and Review. World Journal of Radiology, 5, 304-312.
https://doi.org/10.4329/wjr.v5.i8.304 |
[36] | Makin, E. and Davenport, M. (2012) Understanding Choledochal Mal-formation. Archives of Disease in Childhood, 97, 69-72. https://doi.org/10.1136/adc.2010.195974 |
[37] | Nandalur, K.R., Hussain, H.K., Weadock, W.J., et al. (2008) Possible Biliary Disease: Diagnostic Performance of High-Spatial-Resolution Isotropic 3D T2-Weighted MRCP. Radiology, 249, 883-890.
https://doi.org/10.1148/radiol.2493080389 |
[38] | Tsai, M.S., Lin, W.H., Hsu, W.M., et al. (2008) Clinicopathologi-cal Feature and Surgical Outcome of Choledochal Cyst in Different Age Groups: The Implication of Surgical Timing. Journal of Gastrointestinal Surgery, 12, 2191-2195.
https://doi.org/10.1007/s11605-008-0593-9 |
[39] | Ishibashi, H., Shimada, M., Kamisawa, T., et al. (2017) Japanese Clinical Practice Guidelines for Congenital Biliary Dilatation. Journal of Hepato-Biliary-Pancreatic Sciences, 24, 1-16. https://doi.org/10.1002/jhbp.415 |
[40] | Singham, J., Yoshida, E.M. and Scudamore, C.H. (2010) Choledochal Cysts. Part 3 of 3: Management. Canadian Journal of Surgery, 53, 51-56. |
[41] | Takeshita, N., Ota, T. and Yamamoto, M. (2011) Forty-Year Experience with Flow-Diversion Surgery for Patients with Congenital Choledochal Cysts with Pan-creaticobiliary Maljunction at a Single Institution. Annals of Surgery, 254, 1050-1053. https://doi.org/10.1097/SLA.0b013e3182243550 |
[42] | Narayanan, S.K., Chen, Y., Narasimhan, K.L. and Cohen, R.C. (2013) Hepaticoduodenostomy versus Hepaticojejunostomy after Resection of Choledochal Cyst: A Systematic Re-view and Meta-Analysis. Journal of Pediatric Surgery, 48, 2336-2342. https://doi.org/10.1016/j.jpedsurg.2013.07.020 |
[43] | Shi, L.B., Peng, S.Y., Meng, X.K., et al. (2001) Diagnosis and Treatment of Congenital Choledochal Cyst: 20 Years’ Experience in China. World Journal of Gastroenterology, 7, 732-734. https://Doi.Org/10.3748/Wjg.V7.I5.732 |
[44] | Kim, J.W., Moon, S.H., Park, D.H., et al. (2010) Course of Choledochal Cysts According to the Type of Treatment. Scandinavian Journal of Gastroenterology, 45, 739-745. https://doi.org/10.3109/00365521003675054 |