专题研究(Monographic Study)

胆囊结肠瘘的临床分析:附14例报告

Published at: 2016年第25卷第8期

李明 1 , 孙维佳 1 , 陆晔斌 1 , 黄耿文 1 , 李宜雄 1
1 中南大学湘雅医院 胰腺胆道外科,湖南 长沙410008
通讯作者 维佳 孙 Email: sunweijia2009@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.08.009
基金:

摘要

目的:探讨胆囊结肠瘘的临床特点。方法:回顾性分析中南大学湘雅医院15年来收治的8 235例胆囊结石患者中确诊的14例胆囊结肠瘘患者的临床、病理、随访等资料。结果:胆囊结肠瘘在胆石症患者中的发生率为0.17%(14/8 235);14例患者中,术前确诊2例(14.28%),其余为术中确诊;残余胆囊与横结肠间形成内瘘1例,胆囊体部与横结肠间形成内瘘2例,因胆囊萎缩后胆囊瘘口位置不明1例,其余10例胆囊与横结肠瘘口均位于胆囊底部。14例患者均行胆囊切除术,结肠瘘口行I期修补缝合术12例,行部分结肠切除、吻合术2例;术后切口和膈下感染各1例(7.14%)。结论:对于高度怀疑胆囊结肠瘘患者,运用ERCP等多种检查有助于提高其术前确诊率。


Clinical analysis of cholecystocolonic fistula: a report of 14 cases

Abstract

Objective: To investigate the clinical characteristics of cholecystocolonic fistula. Methods: The clinical, pathological and follow-up data of 14 patients with cholecystocolonic fistula, who were discovered among 8 235 patients admitted for gallbladder stones over the past 15 years in Xiangya hospital, were retrospectively analyzed. Results: The incidence of cholecystocolonic fistula in cholelithiasis patients was 0.17% (14/8235). Of the 14 patients, 2 cases (14.28%) were correctly diagnosed before operation, the other cases were found during operation; one case had internal fistula formation between the residual gallbladder and the transverse colon, 2 cases had internal fistula formation between the body of gallbladder and the transverse colon, the fistulous opening of the gallbladder in one case was uncertain due to atrophy of gallbladder, and in the other 10 cases, the fistulous tracts were all located between the fundus of the gallbladder and the transverse colon. All 14 patients underwent cholecystectomy, 12 patients had primary repair of colonic fistula and 2 patients received partial colectomy and anastomosis. Postoperative infection occurred in 2 patients (7.14%), of which one was wound infection and the other was subphrenic infection. Conclusion: In patients with a high suspicion of cholecystocolonic fistula, using ERCP and other examinations may help improve its preoperative detection rate.


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引用

引用本文: 明 李, 维佳 孙, 晔斌 陆, 耿文 黄, 宜雄 李. 胆囊结肠瘘的临床分析:附14例报告 [J]. 中国普通外科杂志, 2016, 25(8): 1139-1144.
Cite this article as: LI Ming, SUN Weijia, LU Yebin, HUANG Gengwen, LI Yixiong . Clinical analysis of cholecystocolonic fistula: a report of 14 cases[J]. Chin J Gen Surg, 2016, 25(8): 1139-1144.