胆囊十二指肠瘘伴胆石性肠梗阻1例分析并文献复习
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方路, Email: fanglu@medmail.com.cn

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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)。


Cholecystoduodenal fistula with gallstone ileus: an analysis of one case and literature review
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    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。

    Abstract:

    Objective: To investigate the preoperative evaluation, diagnosis and surgical approach of cholecystoduodenal fistula 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: The 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. Then, enterotomy and stone removal, duodenal fistula repair and cholecystectomy were successfully performed. The patient was discharged after postoperative recovery, and no related complications were observed up to the present time. Conclusion: Cholecystoduodenal fistula 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 specific characteristics of individuals.

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陈海敏, 方宏才, 吕亚军, 梁博, 袁荣发, 张军, 胡双辉, 方路.胆囊十二指肠瘘伴胆石性肠梗阻1例分析并文献复习[J].中国普通外科杂志,2018,27(8):1030-1034.
DOI:10.3978/j. issn.1005-6947.2018.08.012

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  • 收稿日期:2018-05-20
  • 最后修改日期:2018-07-23
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  • 在线发布日期: 2018-08-15