微创保胆取石术治疗小儿胆囊结石30例报告  

The experiences of mini-invasive gallbladder-preserving cholelithotomy in 30 children with cholecystolithiasis

作　　者：何建峰[1] 唐勇[1] 

机构地区：[1]重庆黔江中心医院,重庆409000

出　　处：《腹腔镜外科杂志》2012年第5期385-387,共3页Journal of Laparoscopic Surgery

基　　金：重庆市黔江区科学技术委员会社会事业科技计划项目(编号:2010-9-20)

摘　　要：目的:探讨内镜微创保胆取石术治疗小儿胆囊结石的手术方法及临床疗效。方法:回顾分析2006年3月至2011年3月为30例胆囊结石患儿行腹腔镜联合胆道镜直视下保胆取石术的临床资料。患儿均全身麻醉,常规建立气腹,3孔法施术。结果:27例成功施行微创保胆取石术,成功率90%;3例中转腹腔镜胆囊切除术,其中1例腹腔粘连,胆囊壁厚,1例胆囊坏疽,1例胆囊充满型结石。患儿术后均恢复良好,未发生严重并发症。术后1周内复查B超无结石残留。住院4～8 d,平均6 d,切口愈合良好。术后随访全部患儿3～48个月,1例术后1年复发,予以切除胆囊。结论:微创保胆取石术操作简单、安全、可行,是保留胆囊功能的有效方法,特别适合生长发育阶段的患儿。Objective：To investigate the techniques and clinical effects of mini-invasive surgery for removal of calculus and preservation of gallbladder to treat cholecystolithiasis in children.Methods：The clinical data of 30 children who suffered cholecystolithiasis and underwent mini-invasive surgery for removal of calculus and preservation of gallbladder with laparoscope and choledochoscope from Mar.2006 to Mar.2011 were retrospectively analyzed.Patients underwent general anesthesia,pneumoperitoneum was routinely established,and 3-port procedure was performed.Results：Mini-invasive surgery for removal of calculus and preservation of gallbladder were successfully performed in 27 cases with a success rate of 90%.Laparoscopic cholecystectomy were performed in 3 cases,including 1 case of celiac adhesion and thick gallbladder wall,1 case of gallbladder gangrene and 1 case of gallbladder full of stones.All patients recovered uneventfully after operation without severe complications.Their incisions healed well.B-ultrasonography was performed in 1 week to show no residual stones.The mean hospital stay was 6 d（4-8 d）.All the patients were followed up for 3-48 months.Calculi recurrence occurred in 1 case 1 year after surgery and open cholecystectomy was performed.Conclusions：Mini-invasive surgery for removal of calculus and preservation of gallbladder is simple,safe and feasible,which is an effective method to preserve the function of gallbladder and is especially fit for the children in the period of growth and development.

关 键 词：胆囊结石病 保胆取石术 腹腔镜检查 儿童 

分 类 号：R726.5[医药卫生—儿科]