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題名 | Manifestations and Surgical Treatment of Choledochal Cyst in Different Age Group Patients=總膽管囊腫在不同年齡病患之表症及手術治療 |
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作者 | 賴鴻緒; 杜元超; 陳維昭; 陳秋江; 洪文宗; 李伯皇; 黃秀芬; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 96:4 1997.04[民86.04] |
頁次 | 頁242-246 |
分類號 | 416.247 |
關鍵詞 | 總膽管囊腫; 手術治療; Choledochal cyst; Age; Symptom; |
語文 | 英文(English) |
英文摘要 | Whether early surgery is necessary for asymptomatic choledochal cyst is still controversial. In order to evaluate the manifestations of choledochal cyst on different age group patients, we investigated 57 patients, 36 females and 21 males, who underwent surgery for choledochal cyst at National Taiwan University Hospital from July 1988 to June 1995. Of these, 93% were classified as type I according to the Alonzo-Lej or Todani classification method. Patients were divided into three groups according to their age at surgery: group I, 14 infants (<1-yr); group II, 28 children (1-16yr); and group III, 15 adults (> 16yr). The most common symptom in infants was jaundice, while abdominal pain was the most frequent in children and adults. Preoperative evaluation of liver function showed that alanine aminotransferase was higher in group II (160 ± 77 IU/L) and group III (164 ± 75 IU/L) than group I (74 ± 28 IU/L). A higher tendency of biliary sludge and stone formation was noticed in group III (6/15, 40%) when compared with group I (2/14, 14.3%) and group II (5/28, 17.9%). The incidence of high bile amylase concentration in the choledochal cyst was higher in groups II (16/21, 76.2%) and III (9/11, 81.8%) than in group I (2/9, 22.2%). There were more inflammatory changes detected in the choledochal cyst wall and gall bladder by histologic examination in older patients (groups II and III). Therefore, an early surgery for choledochal cyst is suggested for prevention of liver injury, biliary sludge, stone formation and pancreatitis. |
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