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《經(jīng)臍單切口腹腔鏡肝管空腸roux en y吻合術(shù)治療兒童膽總管囊腫的探討.doc》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、經(jīng)臍單切口腹腔鏡肝管空腸Roux-en-Y吻合術(shù)治療兒童膽總管囊腫的探討刁美孫旭李龍董寧李碩侯文英明安曉鄭偉首都兒科研究所【摘要】：目的：評(píng)價(jià)經(jīng)臍單切口腹腔鏡M用傳統(tǒng)腹腔鏡器械治療膽?總管囊腫患兒的安全性和有效性。方法：I叫顧性分析2011年4月至7月間在我中心經(jīng)臍單切口腹腔鏡技術(shù)治療的19例腹總管囊腫患兒預(yù)后和短期隨訪結(jié)果，并與我屮心以往傳統(tǒng)4孔腹腔鏡手術(shù)治療膽總管囊腫的療效對(duì)比。結(jié)果：屮位隨訪時(shí)問(wèn)為3個(gè)月。其屮2例患兒屮轉(zhuǎn)為傳統(tǒng)4孔腹腔鏡手術(shù)，其余17例患兒成功完成經(jīng)臍單切口腹腔鏡下膽總管囊腫根治手術(shù)（
2、平均手術(shù)年齡:3歲，男/女：12/5）。早期單切口手術(shù)屮一例患兒術(shù)后出現(xiàn)膽?漏，腹腔引流10天后自愈。單切口組的平均手術(shù)時(shí)間與我院傳統(tǒng)腹腔鏡肌總管囊腫根治術(shù)時(shí)間無(wú)顯著差異（3.06小時(shí)vs3.04小時(shí)，p=0.909）o兩組的術(shù)后平均住院時(shí)間、術(shù)后恢復(fù)進(jìn)食時(shí)間、腹腔引流留置時(shí)問(wèn)亦無(wú)明顯差異（p=0.056,0.472,0.619）。結(jié)論：經(jīng)臍單切口腹腔鏡應(yīng)用傳統(tǒng)腹腔鏡器械治療膽總管囊腫是安全的,短期隨訪結(jié)果與傳統(tǒng)腹腔鏡療效相仿，為膽?總管囊腫外科治療提供了新的途徑?！娟P(guān)鍵詞】：?jiǎn)吻锌?、腹腔鏡、膽總管囊腫、肝
3、管空腸吻合術(shù)、兒童。UmbilicalSingle-IncisionLaparoscopicRoux-en?YHepaticojejunostomyforChildrenwithCholedochalCystsDIAOMeiSUNXuLILongDONGNingLIQiHOUWen-yingMTNGan-xiaoZHENGWeiCapitalInstituteofPediatricsIAbstract]ObjectiveToevaluatethesafetyandefficacyofumbilicalsin
4、gle-incisionlaparoscopichcpaticojcjunostomy(SILH)forCDCinchildren.MethodsWcreviewed19childrenwhounderwentSILHbetweenAprilandJune2011.Earlypostoperativeandfollow-upresultswerecomparedwithourhistoricalconventionallaparoscopichepaticojejunostomy(CLH)controls.
5、ResultsThemedianfollow-upperiodwas3months.Twoprocedureswereconvertedtotheconventional4-portlaparoscopichepaticojejunostomies.SILHwassuccessfullycompletedin17paticnts(mcdianagc:3.00ycars,F/M:12/5).Earlyintheseries,onepatientdevelopedbileleakwhichstoppedspon
6、taneouslyafter10daysofdrainage.ThemeanoperativetimeoftheSILHgroupdidnotdifferfromthatofourCLHcontrols(3.06hoursvs3.04hours,p=0.909).Theaveragepostoperativehospitalstay,timetoflillfeedanddurationofdrainageintheSILHgroupwerecomparabletoourhistoricalcontrolso
7、fCLH(p=0.056,0.472,0.619respectively).ConclusionSTLHissafeanditsshort?tcrmresultsarccomparabletoCLH.ItpotentiallyprovidesaviablesurgicalalternativeforCDC.【Keywords】:single-incision,laparoscopy,choledochalcysts,hepaticojejunostomy,children.單孔腹腔鏡技術(shù)越來(lái)越多地運(yùn)用于成人
8、外科領(lǐng)域，并開(kāi)始運(yùn)用與小兒，如：膽囊切除術(shù)、幽門(mén)肌切開(kāi)術(shù)、腹股溝疝修補(bǔ)術(shù)、精索靜脈高位結(jié)扎術(shù)、Nissen胃底折疊術(shù)、巨結(jié)腸Pullthrough手術(shù)，但最多運(yùn)用于兒童闌尾切除術(shù)〔T。我們通過(guò)與傳統(tǒng)腹腔鏡手術(shù)療效的對(duì)比，評(píng)價(jià)經(jīng)臍單切口腹腔鏡丿應(yīng)用傳統(tǒng)腹腔鏡器械行膽總管囊腫切除、肝管空腸Roux-en-Y吻合術(shù)的安全性及可行性。1.資料和方法冋顧性分析2011年4月至7月我屮心經(jīng)臍單切口腹腔鏡應(yīng)用傳統(tǒng)腹腔鏡器械治療
