| 摘要: |
| ［摘要］ 目的 探讨完全单切口腹腔镜胆总管囊肿切除、肝管空肠Roux-en-Y吻合术（TSILH）治疗小儿先天性胆总管囊肿的可行性及安全性。方法 回顾性分析2018年1月至2023年3月在上海交通大学医学院附属上海儿童医学中心贵州医院行单切口腹腔镜相关手术的97例患儿的临床资料。根据手术方式将患儿分为TSILH组41例和单切口腹腔镜胆总管囊肿切除、肝管空肠Roux-en-Y吻合术（SILH）组56例。比较两组术中、术后指标以及并发症发生率。结果 所有患儿均顺利在腹腔镜下完成手术，无中转开腹手术及常规多孔腹腔镜手术。TSILH组手术时间［（195.60±13.75）min］长于SILH组［（173.20±34.38）min］，术中空肠端侧吻合时间［（65.75±8.02）min］也长于SILH组［（36.88±5.43）min］，差异有统计学意义（P<0.05）。两组术中出血量、术后恢复饮食时间、术后拔除腹腔引流管时间、术后住院时间及术后并发症发生率比较差异无统计学意义（P>0.05）。结论 TSILH治疗小儿先天性胆总管囊肿安全可行，效果良好，切口美观，但整体手术时间相对延长，要求术者有较高的腹腔镜下吻合技术。 |
| 关键词: 完全单孔腹腔镜 儿童 先天性胆总管囊肿 肝管空肠Roux-en-Y吻合术 |
| DOI：10.3969/j.issn.1674-3806.2025.06.07 |
| 分类号:R 726.5 |
| 基金项目:贵州省科技计划项目［编号：黔科合成果LC（2025）一般144］ |
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| Analysis on total single-incision laparoscopic treatment of congenital choledochal cysts in 41 pediatric patients |
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ZHOU Zhou, ZHUANG Yize, ZHANG Jie, LUO Miao, LI Fei, FAN Xia, HUANG Huang, QIN Zhijie, TANG Yingming
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Department of Pediatric General Thoracic and Hemangioma Surgery, Guizhou Branch of Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, Guiyang 550005, China
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| Abstract: |
| ［Abstract］ Objective To explore the feasibility and safety of total single-incision laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy(TSILH) for the treatment of congenital choledochal cysts in pediatric patients. Methods A retrospective analysis was conducted on the clinical data of 97 pediatric patients who underwent single-incision laparoscopic-related operations in Guizhou Branch of Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine from January 2018 to March 2023. According to surgical procedures, the pediatric patients were divided into TSILH group(n=41), and single-incision laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy(SILH) group(n=56). The intraoperative and postoperative indicators and the incidence of complications were compared between the two groups. Results The operations in all the pediatric patients were successfully completed under laparoscopy, without conversion to laparotomy or conventional multi-port laparoscopic surgery. The operation time in the TSILH group［(195.60±13.75)min］ was longer than that in the SILH group［(173.20±34.38)min］, and the time for end-to-side jejunal anastomosis during the operation in the TSILH group［(65.75±8.02)min］ was also longer than that in the SILH group［(36.88±5.43)min］, with statistically significant differences between the two groups(P<0.05). There were no statistically significant differences between the two groups in terms of intraoperative blood loss, time for resuming diet after operation, time to remove the abdominal drainage tube, length of hospital stay after operation, and the incidence of complications(P>0.05). Conclusion TSILH is a safe and feasible treatment for pediatric congenital choledochal cysts, with good outcomes and satisfactory incisions. However, the overall operation time is relatively prolonged, and it requires a high level of laparoscopic anastomosis skill in the surgeons. |
| Key words: Total single-port laparoscopy Children Congenital choledochal cysts Roux-en-Y hepaticojejunostomy |
