腹腔镜在婴幼儿阻塞性黄疸诊治的价值  

ROLE AND SIGNIFICANCE OF EXTRAHEPATIC CONTROL OF HEPATIC VEIN IN DIFFICULT HEPATECTOMY FOR PATIENTS WITH SECOND PORTA HEPATIC TUMORS

作　　者：高群[1] 黄河[1] 刘翔[1] 卢贤映[1] 吕成超[1] 

机构地区：[1]安徽省立儿童医院儿外科,合肥230051

出　　处：《肝胆外科杂志》2010年第3期189-191,共3页Journal of Hepatobiliary Surgery

基　　金：安徽省医学科研计划资金(编号:07ZA022)

摘　　要：目的探讨腹腔镜胆道造影技术在婴儿阻塞性黄疸诊治中的应用。方法首先由脐部置入腹腔镜观察及肝脏情况,如果胆囊形态基本正常,通过右肋缘下Trocar孔拖出胆囊底,切开胆囊插管行胆道造影,如果胆囊呈纤维闭锁状态,不能拖出腹腔外则中转进腹手术。结果 25例均利用腹腔镜技术行胆道探查、胆道造影明确诊断,其中胆道闭锁18例、胆汁淤积症4例,3例胆道发育不良,据情况分别行胆道冲洗、胆囊造瘘、胆道重建等手术及肝活检术,所有胆道闭锁患儿均行Kasai手术。结论腹腔镜技术用于阻塞性黄疸的早期鉴别诊断及治疗有较高的临床实用价值,对胆汁淤积的患儿,可免除开腹手术。Objective To investigate the value of diagnostic laparoscopy in infants with obstractive jaundice and technique for laparoscopic cholangiography.Methods A 10-mm umbilical trocar was introduced to create a port for a 30-degree laparoscope.If the gallbladder is good size,the fundus was exteriorized through the right subcostal trocar site and a catheter was inserted into the gallbladder for cholangiography.If the fundus could not be exteriorized because of gallbladder atresia,the patient would be converted to an open surgery.Results All the 25 patients were definitely diagnosed by using biliary exploratory operation and cholangiography with peritoneocopy,including 18 case of Biliary atresia.4 case of cholestasis,3 cases of bile duct hypoplasia.Depends on the different disease condition,we applied irrigation biliary tract,biliary syringoplasty,biliary reconstruction and hepatic biopsy.These patients were disgnosed with biliary and then were by Kasai portoenterostomy.Conclusinos Laparoscope is an accurate and reliable technique in the diagnosis and treatment of obstructive jaundice in infants and it can avoid open surgery for infants with cholestasis.

关 键 词：胆道造影 腹腔镜 阻塞性黄疸 婴幼儿 

分 类 号：R657.4[医药卫生—外科学]