摘要
目的对腹腔镜下行巨大先天性胆总管囊肿切除肝管空肠Roux-Y吻合术进行探讨。方法对7例巨大胆总管囊肿(直径11～21cm)行囊肿切除+肝管空肠Roux-Y吻合术。术中行囊肿穿刺减压,切除胆囊,然后从扩张囊肿的中部横断囊肿前壁吸出胆汁,将囊肿壁全层分7～8块逐渐彻底切除。结果7例患儿均顺利完成巨大胆总管囊肿切除+肝管空肠Roux-Y吻合术,无中转开腹手术者。手术时间5.5h～7.6h,平均6.3h;出血量5ml～15ml;6例患儿切除远端囊肿时未找到与胰管相通的管道,仅1例见到明确的远端狭窄的肝管予以结扎。术后无切口感染、胆漏、胰漏和肠梗阻发生,均3d拔除腹腔引流管。术后住院时间4d～6d。随访3个月～19个月,无胆管炎和结石发生,肝功能检查指标均在正常范围内。结论腹腔镜下巨大先天性胆总管囊肿切除、肝管空肠Roux-Y吻合术是一种安全可靠的手术方法。
Objective The aim of this study was to present our experience in laparoscopic excision of huge choledochal cyst in children.Methods seven patients(28days to nine months)with huge choledochal cyst(11cm to21cm in diameter)underwent laparoscopic excision with Roux-Y hepatoenterostomy between July2001to January2003.Under laparoscopic guidance,the dilated choledochal cyst was punctured and decompressed,the huge dilated bile duct were divided into seven to eight pieces and completely excised separatively.Results Median duration of operation was6.3hours(5.5to7.6hours),intraoperative bleeding was5to15ml without blood transfusion necessity.The distal strictured common bile duct was ligated in one case.No incision infection,bile leakage,pancreatic juice leakage and intestinal obstruction were occured after the operation,all abdominal drainage tube were removed at3rd and was missed in the other6cases?Hospital stay ranged from4to6days after the operation without cholangitis and lithogenesis,complication all liver function indicators were normal ranged,followed up for three months to nineteen months followed-up.Conclusion Laparoscope assisted resection of huge choledochal cyst was effective and safe for children with congenital huge choledochal cyst.
出处
《临床小儿外科杂志》
CAS
2003年第4期250-252,共3页
Journal of Clinical Pediatric Surgery
