经脐单切口腹腔镜手术治疗肝外胆道闭锁的初步经验  

Initial experience of single-incision laparoscopic hepaticojejunostomy using conventional instruments for correctable biliary atresia

作　　者：刁美[1] 叶茂[1] 董宁[1] 李颀[1] 侯文英[1] 明安晓[1] 郑伟[1] 李龙[1] 孙旭[1] 

机构地区：[1]首都儿科研究所小儿外科,北京市100020

出　　处：《临床小儿外科杂志》2013年第5期354-357,共4页Journal of Clinical Pediatric Surgery

基　　金：本研究为国家科技支撑计划项目（项目号2006BAI05A06）及北京市科技计划课题（课题号D101100050010064）

摘　　要：目的 介绍单切口腹腔镜肝管空肠吻合术应用于胆道闭锁治疗的初步经验. 方法 2011年5月至7月我们对4例可治愈型胆道闭锁采取单切口腹腔镜肝管空肠吻合术（SILH）治疗,其中Ⅰ型3例,Ⅱ型1例.随访期间进行超声检查、上消化道造影及肝功能检测.评估患儿手术年龄、手术时间、术后住院时间、恢复进食时间、术后并发症以及肝功能检查等指标. 结果 4例患儿中位手术年龄21d,中位手术时间2h,术中出血少.中位随访时间4.5个月,Ⅰ型胆道闭锁患儿术后3～5d,Ⅱ型胆道闭锁患儿术后6d开始黄疸逐渐下降.迄今无一例死亡或出现并发症. 结论 单切口腹腔镜肝管空肠吻合术治疗可治愈型胆道闭锁手术安全,疗效可靠.Objetive Single-incision laparoscopic surgery aims to minimize surgical trauma.Yet there has been no report on its application to the treatment of correctable biliary atresia（BA）.We presented our initial mini-series of successful single-incision laparoscopic hepaticojejunostomy （SILH） for correctable BA.Methods We reviewed 4 correctable BA patients （Type Ⅰ/Ⅱ：3/1） who underwent SILH between May and July 2011.Ultrasonography,upper gastrointestinal contrast studies and blood tests were performed during the follow-up period.The age at operation,operative time,postoperative hospital stay,resumption of full diet,postoperative complications,and perioperative laboratory tests were evaluated.Results The median age at operation was 21 days.The median operative time was 2 hours.Blood loss was minimnal.The median follow-up duration was 4.5 months.Jaundice gradually declined after 3 ～ 5 days in Type Ⅰ and 6 days in Type Ⅱ BA patient.There was no mortality or surgical complication so far.Conclusion In experienced hands,SILH for treatment of correctable BA is safe and effective.

关 键 词：腹腔镜 治疗 胆管 肝外 胆道闭锁 

分 类 号：R725.126[医药卫生—儿科]