腹腔镜技术在难治性婴儿肝炎综合征诊治中的应用体会

The application of laparoscopy in the diagnosis and treatment of intractable infantile hepatitis syndrome

目的:探讨腹腔镜胆道探查、胆道造影在难治性婴儿肝炎综合征诊治中的应用价值。方法:回顾分析2011年2月至2012年11月为71例符合标准的难治性婴儿肝炎综合征患儿行腹腔镜下胆道探查、胆道造影的临床资料,术中根据情况行胆囊造瘘、胆道冲洗、Kasai术。结果:71例均经腹腔镜胆道探查、胆道造影明确诊断,其中胆道闭锁32例,23例行腹腔镜Kasai术;胆汁淤积症36例,胆管发育不良3例,均予以胆囊造瘘、胆道冲洗。结论:腹腔镜胆道探查、胆道造影用于难治性婴儿肝炎综合征的鉴别诊断与治疗具有较高的临床应用价值,值得推广应用。

Objective： To investigate the value of laparoscopic cholangiography and exploration of bile duct in the diagnosis and treatment of infantile hepatitis syndrome. Methods： The clinical data of 71 patients of intractable infantile hepatitis syndrome who re- ceived laparoscopic biliary duct exploration and intraoperative cholangiography from Feb. 2011 to Nov. 2012 were retrospectively ana- lyzed. Cholecystostomy, biliary duct douche or Kasai operation was performed according to different circumstances. Results：All the 71 patients were definitely diagnosed by laparoscopic biliary duct exploration and intraoperative cholangiography, including 32 patients of biliary atresia,23 of them were performed laparoscopic Kasai operation, 36 cases of cholestasis and 3 cases of biliary duct dysplasia which were performed cholecystostomy and biliary duct douche. Conclusions ： Laparoscopie cholangiography and exploration of bile duct is a reliable technique in the diagnosis and treatment of intractable infantile hepatitis syndrome and is worthy to be popularized.