腹腔镜在治疗小儿胰腺疾病中的应用

Laparoscopic surgery for pancreatic diseases in children

目的探讨腹腔镜手术治疗小儿胰腺疾病的临床效果。方法2005年10月至2010年12月应用腹腔镜手术治疗小儿胰腺疾病9例，其中胰腺假性囊肿1例，行囊肿内引流术；局灶性胰岛细胞增生症1例，行单纯胰腺肿瘤切除；弥漫性胰岛细胞增生症2例，胰腺假乳头状瘤3例，行保留脾脏的胰体尾切除术；胰管扩张2例，行扩张胰管空肠侧侧Roux-y吻合术。结果所有手术均获成功，其中完全腹腔镜下完成手术8例，中转开腹手术1例。手术时间140~210min；术中无输血，无十二指肠损伤；术后发生胆瘘1例，经再次开腹手术治愈；术后住院时间3～20d。患儿随访3～24个月，临床症状全部缓解，无任何并发症发生。结论腹腔镜手术治疗部分胰腺疾病是一种安全、有效，可行的手术方法。

Objective To evaluate efficacy of laparoscopy in the treatment of pediatric pancreatic diseases. Methods Nine children with pancreatic diseases underwent laparoscopy surgery between Oc- tober 2005 and December 2010. The procedures included internal drainage of pancreatic pseudocyst （n = 1 ）, excision of islet cell tumor （n = 1 ）, distal panereatectomy for diffuse islet cell hyperplasia （n = 2） and solid-pseudopapillary tumor of pancreas （n = 3）, lateral pancreaticojejunostomy for pancreatic duct dilatation （n = 2）. Results All patients recovered uneventfully. Only one patient was converted to open surgery. Operative time ranged from 140 to 21 （） minutes. No blood transfusion was required. No duode- nal injury was encountered. One patient required redo open surgery for bile leak and recovered. Postop- erative hospital stay was 3-20 days. Follow-up period ranged from 3 to 24 months. No complication was observed. Conclusions Laparoscopic surgery for pancreatic diseases in children is safe, feasible and effective.