经脐单切口腹腔镜开窗引流术治疗小儿先天性肝囊肿  

Umbilical Single Incision Laparoscopic Fenestration for Congenital Hepatic Cyst in Children

作　　者：管考平[1] 侯文英[1] 张军[1] 刘树立[1] 魏延栋[1] 李龙[1] Guan Kaoping;Hou Wenying;Zhang Jun(Department of General Surgery, Affiliated Children’s Hospital of Capital Institute of Pediatrics, Beijing 100010, China)

机构地区：[1]首都儿科研究所附属儿童医院普外科,北京100010

出　　处：《中国微创外科杂志》2021年第5期420-422,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经脐部单切口腹腔镜开窗引流术治疗小儿先天性肝囊肿可行性、安全性。方法2012年3月~2019年3月我科行经脐单孔腹腔镜肝囊肿开窗引流术治疗8例单发性肝囊肿,开窗引流选择肝囊肿最低处,用电钩沿囊壁距肝实质1 cm尽可能多切除囊壁,以求最大限度开窗。结果8例顺利完成经脐单切口腹腔镜肝囊肿开窗引流术,无一例中转开腹。手术时间30~65 min,平均45 min。术中出血量10~25 ml,平均20 ml。术后放置引流管2~5 d,确认无出血、胆漏后拔出。术后住院3~7 d,平均5 d。8例术后随访6~12个月,平均9个月,复查肝脏B超检查,囊肿无复发。结论经脐单切口腹腔镜开窗引流术治疗小儿先天性肝囊肿安全、可行。Objective To evaluate the feasibility and safety of umbilical single incision laparoscopic fenestration for congenital hepatic cyst in children.Methods Between March 2012 and March 2019,8 patients with solitary hepatic cyst were treated by umbilical single incision laparoscopic fenestration.The lowest part of hepatic cyst was selected for fenestration and drainage,and the cyst wall was removed as much as possible by electric hook 1 cm away from the liver parenchyma to maximize fenestration.Results The procedure was successfully performed in all the 8 cases,with no conversion to laparotomy.The operation time was 30-65 min(mean,45 min).The blood loss was 10-25 ml(mean,20 ml).The drainage tube was placed for 2-5 d,and was taken away once bleeding or biliary leakage was excluded.The postoperative hospital stay was 3-7 d(mean,5 d).All the 8 patients were followed up for 6-12 months(mean,9 months),and liver ultrasonic examination found no recurrence of cyst.ConclusionUmbilical single incision laparoscopic fenestration for congenital hepatic cyst in children is safe and feasible.

关 键 词：小儿 腹腔镜 肝囊肿 开窗引流 

分 类 号：R726.5[医药卫生—儿科]