16例先性胆总管囊肿手术治疗体会.docVIP

16例先天性胆总管囊肿手术治疗体会 　　[摘要] 目的 总结先天性胆总管囊肿诊治经验。方法 回顾性分析2014年6月―2016年6月期间收治16例先天性胆总管囊肿患儿的临床资料。结果 13例腹腔镜下顺利完成手术，手术时间平均3.5 h（3～4.5 h），出血量10～30 mL，未输血；3例中转开腹手术，其中1例合并先天性肠旋转不良，1例术前曾行胆囊外引流致腹腔粘连严重，1例因术中出血严重及时中转手术。未发生术后并发症。结论 经腹腔镜胆总管囊肿切除，肝总管空肠Roux-en-Y吻合术是治疗先天性胆总管囊肿的理想方法，术中胆道造影对避免损伤胆胰管连接部和处理肝内胆管狭窄有重要意义。 中国论文网 /6/viewhtm　　[关键词] 胆总管囊肿；胆道造影；腹腔镜术 　　[中图分类号] R657 [文献标识码] A [文章编号] 1674-0742（2017）08（c）-0052-03 　　Treatment Experience of Operation of 16 Cases with Congenital Choledochal Cyst 　　ZOU Jia-liang， DONG Kui-ran， XU Hui-feng， XIA Fan， LIN Yu-ting， LIU Yun-qin 　　Second Department of Surgery， Xiamen Children’s Hospital， Xiamen， Fujian Province， 351000 China 　　[Abstract] Objective To summairze the diagnosdis and treatment expeirnce of congenital choledochal cyst. Methods The clinical data of 16 cases of children with congenital choledochal cyst from June 2014 to June 2016 were retrospectively analyzed. Results 13 cases succesfully finished the laparoscopic surgery， and the average operation time was 3.5 h（3～4.5 h）and the bleeding amount was 10～30 mL， no blood transfusion， 3 cases were converted to open surgery， including 1 case with congenital malrotation of intestine， 1 case with severe abdominal adhesion caused by external biliary drainage of gall bladder， 1 case was converteed to surgery due to severe bleeding in operation， and there were no postoeprative complications. Conclusion The Roux-en-Y anastomosis of common hepatic duct is an ideal method in treatment of congenital choledochal cyst， and intraoperative cholangiography is of important significance to avoiding the injury of biliary and pancreatic junctions and hanlding the intrahepatic bileduct stenosis. 　　[Key words] Choledochal cyst； Cholangiography by cystic duct； Laparoscopic surgery 　　先天性?总管囊肿是常见的胆道发育畸形，其发病与胆胰管合流异常有关。囊肿根治切除、肝总管空肠Roux-en-Y吻合术是其理想的治疗方法，传统开腹手术创伤较大，住院时间长。近年来采用腹腔镜技术治疗胆总管囊肿逐渐成为一个趋势，现将该科自2014年6月―2016年6月完成先天性胆总管囊肿切除术16例，效果良好，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　该组16例术前均经B超、MRCP确诊。其中男3例，女13例；患者年龄3个月～13岁，平均