<症例>先天性胆管拡張症 : 嚢腫空腸吻合で軽快をみず, 嚢腫切除施行の1例

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Although congenital choledochus dilatation (CCD) has been a rare entity of biliary tract diseases, the incidence in the reported cases is higher in the Eastern and Southern Asians. Authors of the collective reviews describe that a third or a half of the cases is Japanese patients. Among the classification of Alonso-Lej, et al., type I is most prevalent. Although complication of gallstone in the CCD has been generally accepted, significant incidence of carcinoma in the bile duct among the patients of CCD is recently recognized. The regurgitation of pancreatic juice into the bile duct following anomalous pancreatico-biliary union is suspected for the carcinogenic factor. Various operative procedures have been considered, and resection of the dilated bile duct, nowadays, seems to be most appropriate. Since the mortality of reoperation is significantly high, if possible, any other surgeries except resection should be avoided. A case of 30-year-old housewife was briefly reported. The signs and symptoms of CCD developed during her pregnancy and diminished following delivery. She underwent cystjejunostomy for the type I of CCD associated with cystic dilatation of the left hepatic duct. Drainage effect was inadequate, and she received jejuno-jejunostomy with Braun's anastomosis one month later. Ascending cholangitis urged her to undergo third surgery ; resection of the cyst of extrahepatic bile duct and anastomosis between the bile duct of porta hepatis and the jejunum (Roux-Y) were performed. Although she suffered from several postoperative complications, she was discharged on the 88th postoperative day with good recovery.
近畿大学の論文
1982-12-25

<症例>先天性胆管拡張症 : 嚢腫空腸吻合で軽快をみず, 嚢腫切除施行の1例

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