腹腔镜用于婴幼儿梗阻性黄疸诊断和治疗的评价

The evaluation of laparoscope in the diagnosis and treatment of obstructive jaundice in infants

目的 探讨腹腔镜在婴幼儿梗阻性黄疸诊断和治疗中的价值。 方法 对 5 2例婴幼儿梗阻性黄疸采用腹腔镜协助诊断和治疗。 结果 2例因大量腹水而中转开腹 ,余 5 0例腹腔镜下行胆道造影明确诊断 ,其中胆道闭锁 33例 ,胆道发育不良 10例 ,胆汁淤积 7例。中转开腹行肝门 -肠吻合术4 3例 ,肝活检 38例 ,胆道置管行胆道冲洗 9例。 结论 腹腔镜诊断和治疗婴幼儿梗阻性黄疸具有准确 ,可靠的优点。对胆汁淤积的患儿 ,可免除开腹手术。

Objective To evaluate the value of laparoscope in the diagnosis and treatment of obstructive jaundice in infants. Methods 52 cases of obstructive jaundice were diagnosed and treated under laparoscope. Results 2 cases were converted to open operation because of a lot of ascitic fluid. The diagnosis of other 50 cases was confirmed under laparoscopic cholangiography, including biliary atresia in 33 cases, bile duct hypoplasia in 10 ones and cholestasis in 7 ones. Hepatic portal-intestinal anastomosis was operated on 43 patients. Liver biopsy was done in 38 cases. Biliary duct cannula and irrigation were performed in 9 cases. Conclusions Laparoscope is an accurate and reliable technique in the diagnosis and treatment of obstructive jaundice in infants and it can avoid open surgery for infants with cholestasis.