儿童轻度扩张的先天性胆管扩张症腹腔镜手术的临床分析

摘要

Objective:To investigate the efficacy,safety and operation experiences of laparoscopic surgery for children with congenital bile duct dilatation of mild dilatation.Method:122 children who received laparoscopic surgery for congenital bile duct dilatation in our hospital from January 2011 to January 2015 were selected as the research objects.25 cases with congenital bile duct dilatation of mild dilatation were selected as the study group,the other 97 cases were selected as the control group.The two groups were all treated with excision of choledochal cyst and hepatic duct jejunum Roux-Y anastomosis.The operation time,bleeding volume during the operation,postoperative eating time,postoperative hospitalization time,incidence of conversions to open surgery and incidence of anastomotic leakage were recorded and compared between the two groups.Result:The operation time and post operation hospitalization duration of the study group were longer than those of the control group,the differences between the two groups were statistically significant(P<0.05).The differences in other indicators of the two groups were not statistically significant(P>0.05).Conclusion:Laparoscopic operation in patients with congenital bile duct dilatation of mild dilatation is relatively safe and the short-term curative effect is exact,but the operation difficulty is greater and the operation time is longer.The operation time shall be grasped more strictly.%目的：探讨腹腔镜手术对儿童轻度扩张的先天性胆管扩张症治疗的安全性和疗效及其手术体会。方法：选择本院2011年1月-2015年1月收治的先天性胆管扩张症腹腔镜手术患儿122例作为研究对象，其中胆总管轻度扩张的25例作为研究组，其余97例作为对照组。两组均采用胆总管囊肿切除及肝总管空肠Roux-Y吻合术进行治疗，记录并比较两组的手术时间、术中出血量、术后进食时间、术后住院时间、中转开放发生情况及吻合口漏发生情况等指标。结果：研究组手术时间及术后住院时间长于对照组，两者比较差异有统计学意义（P<0.05）；两组其他指标比较，差异无统计学意义（P>0.05）。结论：轻度扩张的先天性胆管扩张症施行腹腔镜手术相对安全，近期疗效确切，但手术难度较大，手术耗时更长，需更严格把握手术时机。