胆囊十二指肠瘘伴胆石性肠梗阻1 例分析并文献复习
| 作者: |
1陈海敏,
2方宏才,
3吕亚军,
1梁博,
1袁荣发,
1张军,
1胡双辉,
1方路
1 南昌大学第二附属医院 肝胆外科，江西 南昌 330000 2 九江学院附属医院 肝胆外科，江西 九江 332000 3 江西省湖口县人民医院 普通外科，江西 湖口 332500 |
| 通讯: |
方路
Email: fanglu@medmail.com.cn |
| DOI: | 10.3978/.2018.08.012 |
| 基金: | 国家自然科学基金资助项目（81760438）；江西省重点研发计划基金项目（20171BBG70063）；江西省卫生厅科技 计划基金资助项目（20131077）。 |
摘要
目的：探讨胆囊十二指肠瘘合并胆石性肠梗阻的术前评估、诊断和手术方式。
方法：回顾性分析 1 例胆囊十二指肠瘘合并胆石性肠梗阻术前及术中的临床资料，并复习相关文献。
结果：患者术前 CT 检查考虑胆囊结石与胆石性肠梗阻。术中探查见回盲部 40 cm 处结石嵌顿，随后成功行肠切开取石、十二指肠瘘口修补、胆囊切除。术后痊愈出院，随访至目前未见相关并发症。
结论：胆囊十二指肠瘘合并胆石性肠梗阻临床罕见，早期的明确诊断及精确的评估是关键，应根据患者具体情况选择合适的手术方式。
关键词：
胆囊结石病；胆瘘；肠瘘；十二指肠梗阻
方法：回顾性分析 1 例胆囊十二指肠瘘合并胆石性肠梗阻术前及术中的临床资料，并复习相关文献。
结果：患者术前 CT 检查考虑胆囊结石与胆石性肠梗阻。术中探查见回盲部 40 cm 处结石嵌顿，随后成功行肠切开取石、十二指肠瘘口修补、胆囊切除。术后痊愈出院，随访至目前未见相关并发症。
结论：胆囊十二指肠瘘合并胆石性肠梗阻临床罕见，早期的明确诊断及精确的评估是关键，应根据患者具体情况选择合适的手术方式。
Cholecystoduodenal fistula with gallstone ileus: an analysis of one case and literature review
CorrespondingAuthor:FANG Lu Email: fanglu@medmail.com.cn
Abstract
Objective: To investigate the preoperative evaluation, diagnosis and surgical approach of cholecystoduodenal fi stula with gallstone ileus.
Methods: The clinical data of a patient with cholecystoduodenal fistula and gallstone ileus were analyzed retrospectively, and the relevant literature was reviewed.
Results: Th e patient was considered to have gallbladder stone and gallstone bowel obstruction by preoperative CT examinations. Intraoperative exploration found incarceration of a 40 cm stone at the ileocecal junction. Th en, enterotomy and stone removal, duodenal fistula repair and cholecystectomy were successfully performed. The patient was discharged aft er postoperative recovery, and no related complications were observed up to the present time.
Conclusion: Cholecystoduodenal fi stula with gallstone ileus is a rare condition in clinical practice, early diagnosis and accurate assessment are critical, and appropriate surgical approach should be chosen according to the specifi c characteristics of individuals.
Keywords：
Cholecystolithiasis; Biliary Fistula; Intestinal Fistula; Duodenal Obstruction
Methods: The clinical data of a patient with cholecystoduodenal fistula and gallstone ileus were analyzed retrospectively, and the relevant literature was reviewed.
Results: Th e patient was considered to have gallbladder stone and gallstone bowel obstruction by preoperative CT examinations. Intraoperative exploration found incarceration of a 40 cm stone at the ileocecal junction. Th en, enterotomy and stone removal, duodenal fistula repair and cholecystectomy were successfully performed. The patient was discharged aft er postoperative recovery, and no related complications were observed up to the present time.
Conclusion: Cholecystoduodenal fi stula with gallstone ileus is a rare condition in clinical practice, early diagnosis and accurate assessment are critical, and appropriate surgical approach should be chosen according to the specifi c characteristics of individuals.