全腔镜下成人胆总管囊肿切除术临床疗效分析

Clinical analysis of laparoscopic resection of choledochal cyst under total endoscopy

目的:探讨全腔镜下成人胆总管囊肿切除术的可行性及有效性。方法:回顾性分析2014年9月至2016年11月12例行完全腹腔镜胆总管囊肿切除术成人患者的临床资料,分析完全腹腔镜胆总管囊肿切除术疗效及安全性。所有患者均未行辅助体外吻合术。结果:12例患者均完成全腔镜下胆总管囊肿切除术。平均手术时间为(233.3±73.0)min,术中出血量(53.3±29.9)mL,术后恢复进食时间(4.5±1.5)d,总住院时间(14.7±3.3)d,术后住院时间(8.4±2.4)d。1例患者术后发生胆瘘,1例患者术后吻合口出血,均经保守治疗后顺利出院;无死亡病例。结论:全腹腔镜下成人胆总管囊肿切除术安全可行,值得进一步推广。

Objective：To explore the feasibility and effectiveness of total laparoscopic choledochal cyst excision for adults.Methods：The clinical data of total laparoscopic choledochal cyst excision for 12 adults from September 2014 to November 2016 were retrospectively analyzed, and the efficacy and safety of total laparoscopic choledochal cyst excision were analyzed.All patients did anastomosis in vivo.Results：Total laparoscopic choledochal cyst excision was successfully performed in all of the 12 patients.The mean operation time was （233.3±73.0） min.The mean intraoperative blood loss was （53.3±29.9） mL.The mean time of postoperative feeding was （4.5±1.5） d.The mean duration of hospital stay was （14.7±3.3） d.The mean postoperative hospital stay was （8.4±2.4） d.Biliary fistula occurred in 1 patient, and postoperative anastomotic bleeding in 1 patient.All patients were discharged smoothly after conservative treatment.There were no deaths.Conclusions：Total laparoscopic choledochal cyst excision is safe and feasible, and can be further popularized.