胆囊十二指肠瘘伴胆石性肠梗阻19例诊治分析OA
Diagnosis and treatment analysis of 19 cases of cholecystoduodenal fistula with gallstone ileus
目的:探讨胆囊十二指肠瘘合并胆石性肠梗阻的诊断、治疗及预后.方法:回顾性分析南京医科大学第一附属医院2019年10月—2024年10月收治的19例胆囊十二指肠瘘合并胆石性肠梗阻患者的临床资料.结果:19例患者中男9例,女10例,中位年龄76岁,均因腹部胀痛就诊,既往均有胆石症病史数年.所有患者经影像学确诊后根据结石及患者情况采取肠道切开取石术以及一期或二期胆囊切除和胆囊十二指肠瘘修补术.术后2例出现切口感染,其余均治愈出院,无死亡病例发生.结论:胆囊十二指肠瘘合并胆石性肠梗阻较为罕见,临床表现复杂,常合并多种并发症,围手术期风险较高,应根据患者病情选择个性化的治疗方案.
Objective:To investigate the diagnosis,treatment,and prognosis of cholecystoduodenal fistula complicated with gallstone ileus.Methods:This study retrospectively analyzed clinical data from 19 patients with cholecystoduodenal fistula and gallstone ileus treated at the First Affiliated Hospital of Nanjing Medical University from October 2019 to October 2024.Results:Among the 19 patients,9 were male and 10 were female,with a median age of 76 years.All patients presented with abdominal distension and pain,with a history of cholelithiasis spanning several years.After imaging confirmation,individualized surgical approaches—including enterolithotomy,single-or two-stage cholecystectomy,and fistula repair—were performed based on stone characteristics and patient status.Postoperatively,two cases developed incision infections,while all others recovered and were discharged without mortality.Conclusion:Cholecystoduodenal fistula with gallstone ileus is relatively rare,manifests with complex presentations,often involves multiple complications,and carries high perioperative risks.Personalized treatment strategies should be tailored to individual patient conditions.
李番;王一鸣;周浩明;饶建华;姚爱华;成峰;倪鸣;吕凌
南京医科大学第一附属医院肝胆中心,江苏 南京 210029北京协和医院肝胆外科,北京 100032南京医科大学第一附属医院肝胆中心,江苏 南京 210029南京医科大学第一附属医院肝胆中心,江苏 南京 210029南京医科大学第一附属医院肝胆中心,江苏 南京 210029南京医科大学第一附属医院肝胆中心,江苏 南京 210029南京医科大学第一附属医院肝胆中心,江苏 南京 210029南京医科大学第一附属医院肝胆中心,江苏 南京 210029
医药卫生
胆囊十二指肠瘘胆石性肠梗阻诊断个性化治疗
cholecystoduodenal fistulagallstone ileusdiagnosisindividualized treatment
《南京医科大学学报（自然科学版）》 2026 (2)
256-261,6
中国医学科学院创新单元项目(2019-I2M-5-035)
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