切换至 "中华医学电子期刊资源库"
高级检索
中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (06) : 352 -355. doi: 10.3877/cma.j.issn.1674-6899.2018.06.010

所属专题： 经典病例； 文献；

论著

儿童胆总管囊肿腹腔镜治疗的技术细节分析(附36例报告)
卜浩1, 成伟1,†(), 尹新民1, 陈梅福1, 周洋1, 周磊1, 彭创1, 蒋波1   
  1. 1. 410005　长沙，湖南省人民医院肝胆外科
  • 收稿日期:2018-10-29 出版日期:2018-12-30
  • 通信作者: 成伟
  • 基金资助:
    长沙市科技局一般项目(KQ1701051)

Technical details in laparoscopic treatment of choledochal cyst in children: a report of 36 cases

Hao Bu1, Wei Cheng1,†(), Xinmin Yin1, Meifu Chen1, Yang Zhou1, Lei Zhou1, Chuang Peng1, Bo Jiang1   

  1. 1. Department of Hepatobiliary Surgery, Hunan Provincial People′s Hospital, Changsha 410005, China
  • Received:2018-10-29 Published:2018-12-30
  • Corresponding author: Wei Cheng
  • About author:
    Corresponding author: Cheng Wei, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

卜浩, 成伟, 尹新民, 陈梅福, 周洋, 周磊, 彭创, 蒋波. 儿童胆总管囊肿腹腔镜治疗的技术细节分析(附36例报告)[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(06): 352-355.

Hao Bu, Wei Cheng, Xinmin Yin, Meifu Chen, Yang Zhou, Lei Zhou, Chuang Peng, Bo Jiang. Technical details in laparoscopic treatment of choledochal cyst in children: a report of 36 cases[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(06): 352-355.

目的

分析儿童胆总管囊肿腹腔镜治疗的技术细节，以期手术安全、高效的完成。

方法

回顾性分析2014年6月至2018年6月36例湖南省人民医院肝胆外科的儿童胆总管囊肿行腹腔镜治疗的临床资料，尤其关注术中技术细节。

结果

36例患儿均顺利完成腹腔镜胆总管囊肿切除、肝管空肠Roux-en-Y吻合术，手术时间(215±35)min，术中出血量(34±22)ml，术后拔除胃管时间(2.4±1.2)d，术后拔除腹腔引流管时间(6.0±2.2)d，术后恢复饮食时间(2.8±1.0)d，术后住院时间(7.9±1.9)d。有3例患儿出现了术后并发症，发生率为8.3%，无死亡病例。

结论

腹腔镜手术是治疗儿童胆总管囊肿安全、有效的治疗方式，良好的运用Trocar设置、囊肿剥除及消化道重建中的一些技术细节可保证手术安全高效的完成。

关键词: 腹腔镜, 胆总管囊肿, 儿童, Roux-en-Y吻合术
Objective

To improve the safety and efficiency of laparoscopic surgery in children with choledochal cyst through analyzing the technical details during the operating process .

Methods

Clinical data of 36 children who were finally diagnosed as choledochal cyst and receiving laparoscopic treatment were analyzed retrospectively, with emphasis on the intraoperative technical details.

Results

Laparoscopic choledochal cyst resection and hepatojejunostomy with Roux-en-Y anastomosis were completed successfully for all patients, The operation time and volume of intraoperative blood loss were (215±35)minutes and (34±22)ml, The indwelling time of nasogastric tube and abdominal drainage tube were (2.4±1.2)d and (6.0±2.2)d, The resumption time of normal diet was (2.8±1.0)d and the postoperative stay was (7.9±1.9)d . The postoperative complication was found in 3 patients(8.3%) and no deaths occurred.

Conclusions

Laparoscopic surgery is a safe and effective method in treating children with choledochal cyst. Several technical details, including proper trocar setting, cyst-strippings and digestive tract reconstructions, can effectively improve the efficiency and safety of the operation.

Key words: Laparoscopy, Choledochal cyst, Children, Hepatojejunostomy with Roux-en-Y anastomosis
图1 腹腔镜胆总管囊肿切除、肝管空肠Roux－en－Y吻合术
[1]
中华医学会外科学分会胆道外科学组．胆管扩张症诊断与治疗指南(2017版)[J]．中华消化外科杂志，2017，16(8)：767-774.
[2]
中华医学会小儿外科分会腔镜外科学组．腹腔镜胆总管囊肿手术操作指南(2017版)[J]．中华小儿外科杂志，2017，38(7)：485-494.
[3]
Machado NO, Chopra PJ, Alzadjali A, et al. Choledochal cyst in adults: etiopathogenesis, presentation, management, and outcome-case series and review[J]. Gastroenterology Research & Practice, 2015, 2015(5)：602591-602591.
[4]
Farello GA, Cerofolini A, Rebonato M，et al.Congenital choledochal cyst：video-guided laparoscopic treatment[J]．Surg Laparosc Endosc，1995，5(5)：354-358.
[5]
Urushihara N, Fukuzawa H, Fukumoto K, et al. Totally laparoscopic management of choledochal cyst: Roux-en-Y jejunojejunostomy and wide hepaticojejunostomy with hilar ductoplasty[J]. Journal of Laparoendoscopic & Advanced Surgical Techniques, 2011, 21(4)：361-366.
[6]
Diao M, Li L. Role of laparoscopy in treatment of choledochal cysts in children[J]. Pediatric Surgery International, 2013, 29(4)：317-326.
[7]
Qiao G, Li L, Li S，et al. Laparoscopic cyst excision and Roux-en－Y hepaticojejunostomy for children with choledochal cysts in China: a multicenter study[J]. Surgical Endoscopy, 2015, 29(1)：140-144.
[8]
Shen HJ, Xu M, Zhu HY, et al. Laparoscopic versus open surgery in children with choledochal cysts: a meta-analysis[J]. Pediatric Surgery International, 2015, 31(6)：529-534.
[9]
Zhen C, Xia Z, Long L, et al. Laparoscopic excision versus open excision for the treatment of choledochal cysts: a systematic review and meta-analysis[J]. International Surgery, 2015, 100(1)：115-122.
[10]
Matsumoto M, Urushihara N, Fukumoto K, et al. Laparoscopic management for prenatally diagnosed choledochal cysts[J]. Surgery Today, 2016, 46(12)：1-5.
[11]
Margonis GA, Spolverato G, Kim Y, et al. Minimally invasive resection of choledochal cyst: a feasible and safe surgical option[J]. Journal of Gastrointestinal Surgery, 2015, 19(5)：858-865.
[12]
Liuming H, Hongwu Z, Gang L, et al. The effect of laparoscopic excision vs open excision in children with choledochal cyst: a midterm follow-up study[J]. Journal of Pediatric Surgery, 2011, 46(4): 662-665.
[13]
Diao M, Li L, Cheng W. Laparoscopic versus open Roux-en-Y hepatojejunostomy for children with choledochal cysts: intermediate-term follow-up results[J]. Surgical Endoscopy, 2011, 25(5)：1567-1573.
[14]
温哲，刘涛．胆肠吻合术在小儿腹腔镜手术中的应用[J/CD]．中华腔镜外科杂志(电子版)，2016，9(4)：196-199.
[15]
Wang B, Feng Q, Mao JX, et al. Early experience with laparoscopic excision of choledochal cyst in 41 children[J]. Journal of Pediatric Surgery, 2012, 47(12)：2175-2178.
[16]
李索林，张道荣，李英超，等. 胆总管囊肿切除术中胰管损伤的防治[J]. 中华小儿外科杂志，2000，21(4)：211-213.
[17]
Sacher VY, Davis JS, Sleeman D，et al. Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: case series and review[J]. World Journal of Radiology, 2013, 5(8)：304-312.
[18]
李勇，尹强，周小渔，等. 术中胆道造影在先天性胆总管囊肿手术中的应用[J]. 临床小儿外科杂志，2010，9(6)：430-431.
[19]
Gander JW, Cowles RA, Gross R, et al. Laparoscopic excision of choledochal cysts with total intracorporeal reconstruction[J]. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 2010, 20(10)：877-881.
[20]
张皓，李涛，吐尔洪江·吐逊，等. 腹腔镜胆管空肠Roux-en－Y吻合术治疗胆道疾病的探讨[J/CD]．中华腔镜外科杂志(电子版)，2017，10(3)：150-154.
[1] 燕速, 霍博文. 腹腔镜食管胃结合部腺癌根治性切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 13-13.
[2] 母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[3] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[4] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[5] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[6] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[7] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[8] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[9] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[10] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[11] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[12] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
[13] 郭兵, 王万里, 何凯, 黄汉生. 腹腔镜下肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 143-143.
[14] 李凯, 陈淋, 苏怀东, 向涵, 张伟. 超微创器械在改良单孔腹腔镜巨大肝囊肿开窗引流及胆囊切除中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 144-144.
[15] 魏丽霞, 张安澜, 周宝勇, 李明. 腹腔镜下Ⅲb型肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 145-145.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号

AI
小
编
AI小编
你好！我是《中华医学电子期刊资源库》AI小编，有什么可以帮您的吗？