完全腹腔镜下胆总管囊肿切除重建术

Totally laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy

目的探讨完全腹腔镜下胆总管囊肿切除,胆管空肠Roux-en-Y吻合术的手术技巧和安全性。方法本视频展示1例因先天性胆总管囊肿在上海交通大学医学院附属仁济医院胆胰外科施行的完全腹腔镜下胆总管囊肿切除,胆管空肠Roux-en-Y吻合术的临床资料。结果成功完成手术,手术时间240 min,术中出血80 ml,术后1.5d下床活动,术后住院时间8 d,术后未并发胆漏和胰漏。术后随访1年,无反流性胆管炎、黄疸等表现。结论完全性腹镜下胆总管囊肿切除重建术是安全、可靠的,通过技术积累和改进,能缩短手术时间,扩大手术范围。

OBJECTIVE To investigate the surgical practice and safety of totally laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy. METHODS The video presents the clinical data of a patient caused by congenital choledochal cysts undergoing totally laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in department of biliary-pancreatic surgery of Renji Hospital, Shanghai Jiaotong University of Medcine. RESULTS The operation was successfully completed. The operation time was 240 min, the intraoperative blood loss was 80 ml, time to ambulation was 1.5 d and the length of postoperative hospital stay was 8 d respectively. No bile and pancreatic leakage occurred after operation. No postoperative reflux cholangitis and relapse of jaundice was noted in the follow-up of 1 year. CONCLUSION Totally laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy is safe and feasible; operation time can be shortened and resection range can be extended through technical accumulation and improvement.