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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2025, Vol. 18 ›› Issue (02) : 121 -124. doi: 10.3877/cma.j.issn.1674-6899.2025.02.010

临床技术

腹腔镜治疗婴幼儿脑室腹腔分流术后镰状韧带囊肿
李继业1, 张军2, 吴明星1, 宋伟1, 邸飞1,†()   
  1. 1. 100020 首都医科大学附属首都儿童医学中心神经外科
    2. 100020 首都医科大学附属首都儿童医学中心普外科
  • 收稿日期:2025-03-15 出版日期:2025-04-30
  • 通信作者: 邸飞

Laparoscopic treatment of ventriculoperitoneal shunt complication caused by distal catheter isolation inside the falciform ligament in infant hydrocephalus

Jiye Li1, Jun Zhang2, Mingxing Wu1, Wei Song1, Fei Di1,†()   

  1. 1. Department of Neurosurgery, Capital Center for Children's Health, Capital Medical University, 100020, China
    2. Department of General Surgery, Capital Center for Children's Health, Capital Medical University, 100020, China
  • Received:2025-03-15 Published:2025-04-30
  • Corresponding author: Fei Di
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引用本文：

李继业, 张军, 吴明星, 宋伟, 邸飞. 腹腔镜治疗婴幼儿脑室腹腔分流术后镰状韧带囊肿[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(02): 121-124.

Jiye Li, Jun Zhang, Mingxing Wu, Wei Song, Fei Di. Laparoscopic treatment of ventriculoperitoneal shunt complication caused by distal catheter isolation inside the falciform ligament in infant hydrocephalus[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2025, 18(02): 121-124.

目的

探讨婴幼儿脑积水脑室腹腔分流术后镰状韧带囊肿形成原因以及腹腔镜在处理脑室腹腔分流术后腹部并发症中的优势。

方法

回顾性分析2017年9月至2022年9月首都医科大学附属首都儿童医学中心治疗的4例脑室腹腔分流术后发生镰状韧带囊肿的婴幼儿脑积水的临床资料,并复习相关文献。

结果

通过超声和CT检查确诊腹部并发症后,采用腹腔镜切开囊壁,吸除囊液并调整分流管末端保持通畅。术后4例患儿症状均明显改善,脑室相较术前有所缩小。

结论

镰状韧带囊肿的形成与婴幼儿的生理解剖特点及腹腔端导管置入时切口的位置有关,腹腔镜可安全有效地诊断和治疗脑室腹腔分流术后腹部并发症,发挥微创优势。

关键词: 脑积水, 脑室腹腔分流术, 镰状韧带, 腹腔镜手术

Objective

To explore the causes of falciform ligament cyst and the advantages of laparoscopy in the management of abdominal complications after ventriculoperitoneal shunt in infantile hydrocephalus.

Methods

A retrospective analysis and literature review were conducted on the clinical data of four infantile hydrocephalus cases who developed falciform ligament cysts following ventriculoperitoneal shunt surgery at Capital Center for Children's Health, Capital Medical University between Sep. 2017 and Sep. 2022.

Results

After confirming the abdominal complications by ultrasound and CT, the fascia of the falciform ligament was dissected and cerebrospinal fluid was removed. Afterwards, the distal catheter was placed into the peritoneal cavity to keep it unobstructed. Postoperatively, all four infantile patients showed significant clinical improvement, with a noticeable reduction in lateral ventricular size compared to preoperative measurement.

Conclusion

The development of falciform ligament cyst is not only related to the physiological and anatomical characteristics of infants, but also to the abdominal incision of distal catheter placement. Laparoscopy is able to safely and effectively diagnose and treat abdominal complications.

Key words: Hydrocephalus, Ventriculoperitoneal shunt, Falciform ligament, Laparoscopy surgery
图1 腹平片显示不同病例中脑室-腹腔分流管的远端导管固定于腹腔内的圆形缠结结构
图2 腹部CT显示孤立的分流管远端导管在肝脏下方形成囊状结构 注:A.轴位;B.冠状位;C.矢状位;D.3D重建
图3 腹腔镜辅助手术术中情况 注:A.扩张的镰状韧带;B.切开扩张的镰状韧带可见缠结的分流管远端导管;C.取出远端导管,解除分流管梗阻
图4 镰状韧带解剖示意图(改编自Jong-Hoon et al.2016))
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