儿童胰管结石的手术治疗  

Surgical treatments of pancreatic duct stones in children

作　　者：吴垒 张明满[1] 李英存[1] 周婉怡 熊强[1] Wu Lei;Zhang Mingman;Li Yingcun;Zhou Wanyi;Xiong Qiang(Department of Pediatric Surgery,Affiliated Children's Hospital,Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院肝胆外科,儿童发育疾病研究教育部重点实验室,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,400014

出　　处：《中华小儿外科杂志》2019年第11期1015-1019,共5页Chinese Journal of Pediatric Surgery

基　　金：重庆市科技计划项目(cstc 2018 jscx-msybX 0042)。

摘　　要：目的 探讨儿童胰管结石手术治疗的方法.方法 对2016~2017年重庆医科大学附属儿童医院手术治疗的8例胰管结石患儿临床资料进行回顾性分析.其中男3例,女5例,年龄8岁至13岁8个月,中位年龄11岁2个月;所有患儿均由腹部C T和M RC P影像学手段临床确诊,并行手术治疗.结果 全组患儿无死亡病例,术后无胰漏、腹腔感染、吻合口出血等早期并发症;随访时间8~28个月,平均18.12个月,随访期间无糖尿病、脂肪泻等胰腺内外分泌功能不全表现;术后全部患儿腹痛较术前明显缓解,3例偶有腹痛,5例腹痛未再发作,1例术后结石残留,1例术后结石复发.结论 大口径胰管切开取石、胰管空肠侧侧Ro ux-en-Y吻合术治疗儿童胰管结石疗效显著.Objective To explore the surgical approaches for pancreatic duct stones in children . Methods The clinical data were retrospectively analyzed for 8 surgical children with pancreatic duct stones from 2016 to 2017 .There were 3 boys and 5 girls with a median age of 11 .2 (8-13 .8) years .All of them were clinically diagnosed by abdominal computed tomography (CT ) and magnetic resonance cholangiopancreatography (MRCP ) .Results There was no case of mortality .No such early complications as pancreatic leakage ,abdominal infection or anastomotic bleeding occurred .During an average follow-uPperiod of 18 .12 (8-28) months ,there was no manifestation of pancreatic internal/external secretion dysfunction such as diabetes and steatorrhea .Abdominal pain was completely relieved postoperatively .Three cases of occasional and no abdominal pain and 5 cases respectively . Postoperative stone residue and stone recurrence were 1 case and 1 cases respectively .Conclusions Large diameter pancreatic duct incision and Roux-en-Y pancreaticojejunostomy are efficacious for pancreatic duct stones in children .

关 键 词：儿童 胰管结石 胰管空肠吻合术 

分 类 号：R65[医药卫生—外科学]