Objetive To summarize ihe experiences of lolal laparoscopic choledochal cysl excision in children in our hospilal, and explore ihe skill and advanlages of ihis kind of operalion. Methods The clinical materials of 63 cases from April 2010 were analyzed relrospeclively. All palienls underwent ihe laparoscopic choledochal cysl excision and Roux-en-Y hepalicojejunoslomy. Results Among ihe 63 cases, 61 palienls un-derwenl ihe operalion successfully while 2 cases were convened to open operalion. 5 palienls were complicated by biliary-enleric anaslomolic leakage after operalion, 4 of them recovered after drainage while ihe remaining one recovered after reoperalion. The avascular necrosis of jejunal loop was found in 1 case al 3 monlh after operalion, bul il was recovered after reoperalion. No postoperative bleeding, pancrealic fislula, inleslinal anaslomolic leakage, adhesiveileus and refluxing cholangilis were found in all cases. Conclusions Laparoscopic choledochal cysl excision has ihe advantage of bright view, less trauma, good looking after the wound healed, fast recovery, less complications and short hospitalizing lime. It is a safe and effective method and could be the "gold standard" way to deal with congenital choledochal cyst presenting in childhood if doctors can meet the experience and skill requirements.%目的 总结我们开展腹腔镜手术治疗先天性胆管扩张症的经验,探讨腹腔镜手术的技巧及优势.方法 回顾性分析本院自2010年4月以来收治的63例先天性胆管扩张症患儿临床资料,患儿均行腹腔镜下扩张胆总管切除,肝总管空肠Roux-en-Y吻合术.结果 63例患儿中,61例顺利在腹腔镜下完成手术,2例中转开腹手术,5例术后出现胆肠吻合口瘘,其中4例经保守治疗痊愈,1例再次开腹重新吻合后痊愈;1例于术后3个月出现代胆道肠袢缺血坏死,经开腹重新吻合后痊愈;无一例出现术后出血、胰瘘、肠肠吻合口瘘、粘连性肠梗阻、反流性胆道感染等并发症.结论 经腹腔镜行先天性胆管扩张症根治术具有术野清晰、创伤小、切口美观、术后恢复快、并发症少、住院时间短等优势,是一种安全可靠的方法,如果手术者经验和技术符合要求,可作为该病手术治疗的金标准.
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