Guo Jindie,Yang Jun,Bian Hongqiang,et al.Cystic duct cyst in children: one case review and literature analysis[J].Journal of Clinical Pediatric Surgery,2025,(09):882-887.[doi:10.3760/cma.j.cn101785-202409050-015]
儿童胆囊管囊肿1例并文献分析
- Title:
- Cystic duct cyst in children: one case review and literature analysis
- Keywords:
- Cystic Duct Cyst; Choledochal Cyst; Child
- 摘要:
- 目的 探讨儿童胆囊管囊肿的临床特点、诊治及预后。方法 回顾性分析华中科技大学附属武汉儿童医院收治的1例儿童胆囊管囊肿患者临床资料。以“Cystic duct cyst”为检索词，检索PubMed、Web of Science数据库相关文献；以“胆囊管囊肿”为检索词检索万方医学网、中国知网相关文献；检索时间范围1964年2月至2024年9月；排除重复文献后进行文献复习，总结该类疾病的临床、影像学特征以及预后情况。结果 患儿男，8岁，因“胆总管囊肿4个月”入院，术前彩超和腹盆CT检查提示胆总管囊肿；行磁共振胆胰管成像和内镜逆行胰胆管造影术提示胆囊管囊肿；行达芬奇机器人辅助下胆道探查术，术中可见胆囊管扩张，行胆囊与胆囊管囊肿联合切除术，探查胆管于残端放置T管引流，手术顺利。术后病理诊断胆囊管囊肿。术后9 d患儿恢复良好带T管出院。术后6周于门诊复查行T管造影，胆管形态正常，拔除T管，临床治愈。截至目前已随访6个月，患儿预后良好。共获得11篇符合要求文献，共报道11例胆囊管囊肿患儿。其中男4例，女6例，1例未报道性别；平均年龄7.78岁(4个月至15岁)；9例因腹痛就诊，1例因腹痛、右上腹包块、黄疸就诊，1例因黄疸就诊。11例均行手术治疗，术后恢复良好出院。结论 儿童胆囊管囊肿罕见，一般无特异性临床症状。辅助检查亦无明显特殊表现，但磁共振胆胰管成像、内镜逆行胰胆管造影术具有一定的诊断价值；术中见胆囊管扩张是明确诊断的确切依据，对未合并胆管结石、胆总管扩张、胰胆管合流异常等胆道异常的患儿可行胆囊及胆囊管囊肿切除术。
- Abstract:
- Objective To explore the clinical features, diagnoses, treatments and prognoses of cystic duct cyst (CDC) in children. Methods A retrospective analysis was performed for the relevant clinical data of one boy hospitalized with cystic duct cyst."Cystic duct cyst" was employed as a search term for retrieving the relevant literatures of PubMed and Web of Science."Cystic duct cyst" was used as the search term to search the databases of WANFANG and China National Knowledge Infrastructure (CNKI).Searching period started from February 1964 to September 2024; After the duplication of literature was excluded, literature review was performed to summarize the clinical and imaging features and prognoses of these diseases. Results An 8-year-old boy was hospitalized with common bile duct cyst for 4 months.Preoperative color ultrasound and abdominopelvic computed tomography (CT) examination hinted at common bile duct cyst.Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography revealed cystic duct cysts.Da Vinci robot-assisted biliary tract exploration was performed.Cystic duct dilation was detected during operation.Combined resection of gallbladder and cystic duct cyst was performed and bile duct explored for placing a T duct at stump for drainage.Postoperative pathological diagnosis was cystic duct cyst.At Day 9 post-operation, he recovered well and was discharged with a T tube.At Week 6 post-operation, T tube angiography at outpatient clinic indicated that bile duct morphology was normal and T tube was removed.There was clinical cure.During a follow-up period of 6 months, the prognosis was decent.A total of 11 eligible papers were retrieved and a total of 11 CDC children were reported.Among them, there were 4 boys and 6 girls with an average age was 7.78(1/3-15) year.The major manifestations were abdominal pain (n=9), abdominal pain, right upper quadrant mass and jaundice (n=1) and jaundice (n=1).All children were operated and discharged uneventfully. Conclusions CDCs in children are rare and generally lack specific clinical symptoms.There are no obvious special manifestations in auxiliary examinations.However, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography have some diagnostic values.Cystic duct dilation during surgery is a confirmative diagnosis.And gallbladder and cystic duct cystectomy are indicated for children without biliary tract abnormalities such as bile duct stones, common bile duct dilation or abnormal pancreaticobiliary confluence.
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备注/Memo
收稿日期:2024-9-19。
基金项目:武汉市医学科学研究项目(WX23A72)
通讯作者:杨俊，Email：119064715@qq.com