经脐单切口腹腔镜肝管空肠roux-en-y吻合术治疗儿童胆总管囊发肿的探讨.docVIP

经脐单切口腹腔镜肝管空肠Roux-en-Y吻合术治疗儿童胆总管囊肿的探讨 刁美 孙旭 李龙 董宁 李颀 侯文英 明安晓 郑伟 首都儿科研究所 【摘要】：目的：评价经脐单切口腹腔镜应用传统腹腔镜器械治疗胆总管囊肿患儿的安全性和有效性。方法：回顾性分析2011年4月至7月间在我中心经脐单切口腹腔镜技术治疗的19例胆总管囊肿患儿预后和短期随访结果，并与我中心以往传统4孔腹腔镜手术治疗胆总管囊肿的疗效对比。结果：中位随访时间为3个月。其中2例患儿中转为传统4孔腹腔镜手术，其余17例患儿成功完成经脐单切口腹腔镜下胆总管囊肿根治手术（平均手术年龄：3岁，男/女：12/5）。早期单切口手术中一例患儿术后出现胆漏，腹腔引流10天后自愈。单切口组的平均手术时间与我院传统腹腔镜胆总管囊肿根治术时间无显著差异（3.06小时vs3.04小时，p=0.909）。两组的术后平均住院时间、术后恢复进食时间、腹腔引流留置时间亦无明显差异（p=0.056，0.472，0.619）。结论：经脐单切口腹腔镜应用传统腹腔镜器械治疗胆总管囊肿是安全的，短期随访结果与传统腹腔镜疗效相仿，为胆总管囊肿外科治疗提供了新的途径。 【关键词】：单切口、腹腔镜、胆总管囊肿、肝管空肠吻合术、儿童。 Umbilical Single-Incision Laparoscopic Roux-en-Y Hepaticojejunostomy for Children with Choledochal Cysts DIAO Mei SUN Xu LI Long DONG Ning LI Qi HOU Wen-ying MING an-xiao ZHENG Wei Capital Institute of Pediatrics 【Abstract】Objective To evaluate the safety and efficacy of umbilical single-incision laparoscopic hepaticojejunostomy(SILH) for CDC in children. Methods We reviewed 19 children who underwent SILH between April and June 2011. Early postoperative and follow-up results were compared with our historical conventional laparoscopic hepaticojejunostomy(CLH) controls. Results The median follow-up period was 3 months. Two procedures were converted to the conventional 4-port laparoscopic hepaticojejunostomies. SILH was successfully completed in 17 patients(median age:3.00years,F/M:12/5). Early in the series, one patient developed bile leak which stopped spontaneously after 10 days of drainage. The mean operative time of the SILH group did not differ from that of our CLH controls(3.06 hours vs 3.04 hours, p=0.909). The average postoperative hospital stay, time to full feed and duration of drainage in the SILH group were comparable to our historical controls of CLH(p=0.056, 0.472, 0.619 respectively). Conclusion SILH is safe and its short-term results are comparable to CLH. It potentially provides a viable surgical alternative for CDC. 【Key words】：single-incision, laparoscopy, choledochal cysts, hepaticojejunostomy, children. 单孔腹腔