腹腔镜联合胆道镜保胆取石术治疗小儿胆囊结石(附20例报告)  

Laparoscopic combined with choledochoscopic gallbladder-preserving cholelithotomy for the treatment of cholecystolithiasis in children:with a report of 20 cases

作　　者：方志宏[1] 吴峤微[1] 石英佐[1] 朱晓敏[1] FANG Zhi-hong;WU Qiao-wei;SHI Ying-zuo(Department of General Surgery,the Affiliated Wuxi Children's Hospital of Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡市儿童医院普通外科,江苏无锡214023

出　　处：《腹腔镜外科杂志》2021年第9期687-690,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜联合胆道镜保胆取石术治疗小儿胆囊结石的手术技巧及临床价值。方法:回顾分析2018年1月至2019年12月行腹腔镜联合胆道镜保胆取石术的20例胆囊结石患儿的临床资料。其中男8例,女12例;4~12岁。结果:19例成功完成双镜联合保胆取石术,成功率95%;1例因腹腔粘连改行腹腔镜胆囊切除术。手术时间平均(45.211.5)min,术中出血量平均(8.62.3)mL,术后平均住院(3.51.1)d。术后48 h拔除腹腔引流管。术后患儿恢复良好,均无术后出血、胆漏、胆管损伤等并发症发生。术后随访6~12个月,无胆囊结石复发。结论:腹腔镜联合胆道镜保胆取石术治疗小儿胆囊结石是安全、可行的,能保留胆道的完整性与胆囊功能,适合生长发育阶段的儿童,值得有条件的单位推广。Objective:To investigate the techniques and clinical value of laparoscopic combined with choledochoscopic gallbladder-preserving cholelithotomy for children with cholecystolithiasis.Methods:A retrospective analysis was made on the clinical data of 20 children who suffered from cholecystolithiasis and underwent laparoscopic combined with choledochoscopic gallbladder-preserving cholelithotomy from Jan.2018 to Dec.2019.Among them,8 patients were males and 12 were females with the age ranging from 4 to 12 years.Results:Laparoscopic combined with choledochoscopic gallbladder-preserving cholelithotomy was successfully performed in 19 children with success rate of 95%.Laparoscopic cholecystectomy was performed in 1 case because of abdominal adhesion.The surgery time was(45.211.5)min,intraoperative blood loss was(8.62.3)mL,postoperative hospital stay was(3.51.1)d.The abdominal drainage tube was removed 48 h after operation.All patients recovered uneventfully after operation without complications such as postoperative bleeding,bile leakage,biliary duct injury.The patients were followed up for 6-12 months,and the ultrasound showed no gallstone recurrence.Conclusions:Laparoscopic combined with choledochoscopic gallbladder-preserving cholelithotomy is safe and feasible in the treatment of cholecystolithiasis in children,it can preserve the integrity of biliary tract and gallbladder function,and is suitable for children at the age of growth and development.This procedure is worth promotion and application in eligible hospitals.

关 键 词：胆囊结石病 保胆取石术 腹腔镜检查 胆道镜检查 儿童 

分 类 号：R657.4[医药卫生—外科学]