腹腔镜手术治疗成人先天性胆管扩张症14例分析

Totally laparoscopic surgery in the treatment of adult congenital biliary dilatation: an analysis of 14 cases

目的探讨完全腹腔镜下扩张胆管切除、胆肠Roux—en—Y吻合术治疗成人先天性胆管扩张症的可行性与安全性。方法回顾性分析2008年5月至2011年9月中国医科大学附属盛京医院普外科收治的接受完全腹腔镜囊肿切除、肝总管空肠Roux—en—Y吻合手术治疗的14例成人先天性胆管扩张症病人的临床资料。结果14例腹腔镜手术均顺利完成，无中转开腹手术。平均手术时间195min，术中平均失血量80mL，术后平均76h排气或排便，术后平均住院时间6．1d。除1例术后有少量胆汁漏外，无严重术后并发症发生，均顺利恢复。术后随访3。40个月，无腹痛、发热、黄疸等症状。结论完全腹腔镜成人先天性胆管扩张症囊肿切除、肝总管空肠Roux—en—Y术安全可行的，具有创伤小、恢复快的优点，值得推广。

Objective To explore the feasibility and safety of laparoscopic cyst resection and Roux-en-Y hepatojejunostomy in the treatment of adult congenital biliary dilatation（CBD）. Methods The clinical data of 14 cases of adult CBD admitted from May 2008 to September 2011 in Department of General Surgery of Shengjing Hospital of China Medical University were analyzed restrospectively. All the cases received laparoscopic cyst resection and Roux-en-Y hepatojejunostomy. Results All the operations were carried out successfully through laparoscopic surgery. The mean duration of operation was i95 rain. The average intraoperative blood loss was 80 mL. The mean duration of bowel motion recovery and postoperative hospital stay was 76 h and 6.1 days respectively. Except of 1 case with small amount of bile leakage, all cases recovered smoothly without severe postoperative complications. No cases suffered from abdominal pain, fever or jaundice within 3 to 40 months follow up. Conclusion Totally laparoscopic surgery of CBD in adult is feasible and safe. It is worth to be generally applied because of its minimal invasion and fast recovery postoperatively.