腹腔镜辅助与小切口小儿胆总管囊肿根治术的对比研究

Comparative study of laparoscopic-assisted and small-incision radical excision for choledochal cyst in children

目的:探讨腹腔镜辅助胆总管囊肿切除+胆总管空肠Roux-Y吻合术治疗儿童先天性胆管扩张症的有效性与安全性。方法:回顾分析75例先天性胆管扩张症患儿的临床资料,将其分为观察组(行腹腔镜手术,n=23)与对照组(行小切口开放手术,n=52)。对比分析两组手术时间、术中出血量、术后肛门排便时间、术后首次进食时间、引流管拔除时间、术后住院时间、切口大小、术后并发症等指标。结果:两组引流管拔除时间、术后并发症差异无统计学意义(P>0.05);观察组术中出血量、术后肛门排气排便时间、术后首次进食时间、术后住院时间及切口大小明显优于对照组,差异有统计学意义(P<0.05);观察组手术时间长于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜辅助胆总管囊肿切除+胆总管空肠Roux-Y吻合术治疗先天性胆管扩张症是安全、有效的。

Objective： To explore the clinical efficacy and safety of laparoscopic-assisted excision of choledochal cyst and Roux-Y choledochojejunostomy in the treatment of congenital biliary dilatation in children. Methods：A retrospective analysis was performed on the clinical data of 75 patients with congenital biliary dilatation. 23 of them （ observation group） underwent laparoscopic surgery, while the other 52 patients （control group） underwent small-incision open surgery. The operative time ,intraoperative blood loss ,time to first flatus after surgery, eating time after operation, dm-ation of drainage, postoperative hospital stay,length of incision and postoperative complications were compared and analyzed between the two groups. Results：There were no significant differences in duration of drain-age and incidence of postoperative complications （P 〉 0.05 ）. Compared with the control group, the observation group had a significantly longer operative time （ P 〈 0.05 ） ,but significantly less intraoperative blood loss,time to first defecation after surgery, eating time after operation,postoperative hospital stay and length of incision （P 〈 0. 05 ）. Conclusions： Laparoscopic-assisted excision of choledochal cyst and Roux-Y choledoehojejunostomy in the treatment of children with congenital biliary dilatation is safe and feasible.