小儿胆囊结石腹腔镜保胆取石术的应用体会

Application experience of pediatric laparoscopic gallbladder-preserving cholelithotomy for cholecystolithiasis

目的：探讨腹腔镜保胆取石术治疗小儿胆囊结石的可行性及临床疗效。方法：回顾分析2009年5月至2014年5月为14例胆囊结石患儿行腹腔镜保胆取石术的临床资料与疗效。结果：本组14例均顺利完成腹腔镜胆囊切开取石术，无中转胆囊切除术或开腹手术，手术时间35～80min，平均（45±10）min，术后无腹腔内出血、胆漏、切口感染等并发症发生，术后12。24h开始进全流质饮食，术后12h下床活动，术后随访3～8个月，无结石复发。结论：腹腔镜保胆取石术可有效保留胆道完整性及胆囊功能，可提高患儿的生存质量，具有微创、术后疼痛小、康复快、并发症少等优势，安全、可行，值得临床推广应用。

Objective：To investigate the practicability and clinical efficacy of laparoscopic gallbladder-preserving cholelithoto- my in the treatment of pediatric cholecystolithiasis. Methods：The clinical data and curative effect of 14 children who suffered from cho- lecystolithiasis and underwent laparoscopic cholecystolithotomy during May 2009 and May 2014 were retrospectively analyzed. Results： All of 14 laparoscopic operations were successful without conversion to laparoscopic cholecystectomy or open surgery. The operating time ranged from 35 to 80 rain,with an average of （45 ± 10） rain. There were no intra-abdominal hemorrhage,bile leakage ,wound infection or other complications. The patients were able to eat full liquid diet in 12-24 h after surgery, get out of bed within 12 h after surgeries. All cases were followed up for 3-8 months without postoperative recurrence. Conclusions： Laparoscopic gallbladder-preserving chole- lithotomy is an effective method to keep the integrity and function of biliary system, can improve the life quality of children, is safe, fea- sible, mini-invasive and it can be used widely in pediatric cholecystolithiasis because of little pain, rapid recovery, and few complica- tions.