THE DIAGNOSIS AND TREATMENT OF BILIDIGESTIVE AND CHOLECYSTO CHOLEDOCHAL FISTULA DUE TO GALLSTONE DISEASE_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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杨厄 ¹ , 杨汉新 ¹ , 徐蓉 ² , 严修源 ¹

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胆囊结石病内瘘诊断治疗

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目的探讨胆囊结石病引起胆道内瘘的原因，提高其诊断和治疗水平。方法收集我院1990～1999年收治的胆道内瘘患者46例，并对其病因、诊断与治疗进行分析。结果胆囊十二指肠瘘18例（39.1%），胆囊结肠瘘8例（17.4%），胆囊与胃、空肠内瘘各1例（4.3%）；胆囊胆管瘘18例（39.1%）。术后出现并发症4例（8.7%），死亡1例（2.2%），治愈率为97.8%。结论重视本病的临床表现及术前、术中检查，选择恰当手术方式，可减少死亡与并发症的发生。

Citation： 杨厄,杨汉新,徐蓉,严修源. THE DIAGNOSIS AND TREATMENT OF BILIDIGESTIVE AND CHOLECYSTO CHOLEDOCHAL FISTULA DUE TO GALLSTONE DISEASE. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(5): 356-357. doi: Copy

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1. Dorrance HR, Lingam MK, Hair A, et al. Acquired abnormalities of the biliary tract from chronic gallstone disease [J]. J Am Coll Surg, 1999; 189(3)∶269.
2. Glenn F, Reed C, Grafe WR. Biliary enteric fistula [J]. Surg Gynecol Obstet, 1981; 153(4)∶527.
3. Tanaka N,Nobori M,Furuya T,et al.Evolution of Mirizzi syndrome with biliobiliary fistula [J].J Grastroenterol, 1995; 30(1)∶117.
4. 黄耀权，孙艳化. 胆囊结石病的并发症. 见：黄志强主编. 当代胆道外科学 [M]. 上海：科学技术文献出版社， 1998∶318～323.
5. Ravo B, Epstien H, La Mendola S, et al. The Mirizzi’s syndrome peroperative diagnosis by sonography and transhepatic cholangiogrophy [J]. Am J Gastroenterol, 1986; 81(8)∶688.
6. Kim PN, Outwater EK, Mitchell DG. Mirizzi syndrome: evaluation by MRI imaging [J]. Am J Gastroenterol, 1999; 94(9)∶2546.
7. Zwemer FL,CoffinKwart VE,Conway MJ.Biliary enteric fistulas. Management of 47 cases in native Americans [J].Am J Surg,1979; 138(2)∶301.
8. Yip AW, Chow W, Chan J, et al. Mirizzi syndrome with cholecystocholedochal fistula: preoperative diagnosis and management [J]. Surgery, 1992; 111(3)∶335.
9. 刘永雄，黄志强. 损伤性胆管狭窄的外科治疗 [J]. 普外临床，1986； 3（3）∶234.
10. Baer HU, Matthews JB, Schweizer WP, et al. Management of the Mirizzi syndrome and the surgical implications of cholecystcholedochal fistula [J]. Br J Surg, 1990; 77(7)∶743.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

THE DIAGNOSIS AND TREATMENT OF BILIDIGESTIVE AND CHOLECYSTO CHOLEDOCHAL FISTULA DUE TO GALLSTONE DISEASE

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