全腹腔镜下成人先天性胆管扩张症治疗策略

Laparoscopic therapeutic strategies for adult congenital biliary dilatation

先天性胆管扩张症主要的治疗手段是切除扩张的胆管和行胆肠Roux-en-Y吻合。腹腔镜囊肿切除、胆肠吻合术开展已十余年,在小儿外科全腹腔镜下手术治疗先天性胆管扩张症开展相对较多,成人开展甚少。已有研究表明该术式疗效确实可靠,同时具有损伤小、术后恢复快的优势,尚未得到广泛开展的主要原因是手术难度大、技术要求高。掌握腹腔镜下操作技巧和术中注意事项,有助于该术式的推广与普及,使更多的病人从中获益。

The classic therapeutic procedure for congenital biliary dilatation（CBD） is excision of pathological bile ducts plus Roux-en-Y hepaticojejunostomy. Since laparoscopic choledochal cyst excision plus Roux-en-Y hepaticojejunostomy had been applied more than 10 years ago, it was used mainly in pediatiic surgery and seldom in adult patients. Some researchers had reported that the procedure had certain therapeutic effect with minimal injury and fast postoperative recovery. The complex operative procedure and high specification limited its widespread. It is necessary to master laparoscopic operative skills and intraoperative principle in order to spread the technique and more patients could get benefit from it.