成人型胆总管囊肿的机器人手术疗效分析

Resection of adult choledochal cysts using robotic surgical system

目的：探讨成人型胆总管囊肿机器人辅助手术治疗的有效性、安全性及临床疗效。方法 ：回顾分析2010-2014年间我院应用机器人手术系统治疗4例成人型胆总管囊肿病人,行＂胆总管囊肿切除加Roux-en-Y胆肠吻合术＂的临床资料,与同期12例开腹手术治疗资料进行对比分析。结果：机器人组手术均获成功,无一例中转开腹。机器人组手术时间（127.5±35.0）（90-170）min,术中出血量（25.0±28.9）（0-50）m L,术中、术后均未输血,术后住院时间（11.8±3.9）（8-16）d。机器人组手术时间及术中出血量均少于开腹组（P〈0.05）。随访5-31个月,无特殊症状及其他并发症。结论：应用机器人手术系统行胆总管囊肿切除加Roux-en-Y胆肠吻合术安全、可行,手术创伤小,术后恢复快。

Objective To investigate the feasibility, security and efficacy of robot-assisted surgery in resection of adult choledochal cysts. Methods The clinical data of 4 patients with the resection of choledochal cysts and Roux-en-Y hepaticojejunostomy using robotic surgical system from 2010 to 2014 were analyzed retrospectively. A comparative study was made with 12 patients who underwent open resection of choledochal cysts and Roux-en-Y hepaticojejunostomy. Results All the operations were performed successfully both in robotic group without the conversion to laparotomy and in open group. The operation time was（127.5±35.0）（90-170） min with blood loss（25.0±28.9）（0-50） m L. No transfusion was given during and after the operation. The postoperative hospital stay was（11.8 ±3.9）（8-16） days. The operation time was shorter and the blood loss less in the robotic group than in the open group（P〈0.05）. No complications was found during the period of follow-up 5-31 months. Conclusions The resection of adult choledochal cysts and Roux-en-Y hepaticojejunostomy with robot-assisted surgery is secure and feasible with the advantages of mini-invasive and quick recovery.