改良三孔法与常规四孔法腹腔镜手术治疗小儿先天性胆总管囊肿的对比研究  

The comparative study of modified three-port laparoscopy and conventional four-port laparoscopy in the treatment of pediatric congenital choledochal cyst

作　　者：欧作强 蒋丹华 黄高杰 李永明 黄名 刘萍萍[1] 曾甜[1] OU Zuo-qiang;JIANG Dan-hua;HUANG Gao-jie(Department of Neonatal Surgery,the Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Guangxi Clinical Research Center for Pediatric Diseases,Nanning 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院新生儿外科、广西儿科疾病临床研究中心,广西南宁530003

出　　处：《腹腔镜外科杂志》2023年第2期138-143,共6页Journal of Laparoscopic Surgery

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2020059);广西壮族自治区科学技术厅科技计划项目(桂科AD22035121)。

摘　　要：目的:探讨改良三孔法腹腔镜手术治疗小儿先天性胆总管囊肿的可行性、安全性及手术效果。方法:回顾分析2015年9月1日至2022年3月1日收治的95例先天性胆总管囊肿患儿的临床资料,根据手术方法分为三孔组(n=30)与四孔组(n=65),对比分析两组围术期各项指标及术后并发症发生率。结果:两组手术时间、术中出血量、术后并发症、术后禁食时间、腹腔引流管拔除时间、术后住院时间、术中术后输血情况差异无统计学意义(P>0.05)。结论:改良三孔法腹腔镜手术治疗小儿先天性胆总管囊肿疗效较好、安全可靠、微创、费用家属可承受,与常规四孔法相比,术中、术后观察指标及术后并发症发生率相当,但术中减少了一枚Trocar与1位助手,术后切口疤痕不明显,术者需具备熟练的腹腔镜手术技巧。Objective:To discuss the possibility,safety and surgical effect of modified three-port laparoscopic surgery for pediatric congenital choledochal cyst.Methods:The clinical data of 95 children with congenital choledochal cyst from Sep.1,2015 to Mar.1,2022 were retrospectively analyzed.According to the surgical methods,patients were divided into the modified three-port group(n=30)and the conventional four-port group(n=65).The perioperative characteristics and postoperative complications were compared between the two groups.Results:There were no statistically significant differences between the two groups in operation time,intraoperative blood loss,postoperative complications,postoperative fasting time,abdominal drainage tube removal time,postoperative hospital stay,intraoperative and postoperative blood transfusion(P>0.05).Conclusions:The modified three-port laparoscopic surgery is effective,safe,reliable,minimally invasive and affordable in the treatment of pediatric congenital choledochal cyst.Compared with the conventional four-port method,in modified three-port method the perioperative characteristics and postoperative complications incidence are comparable,but one Trocar and one assistant are reduced in operation,and postoperative incision scars are not obvious.Meanwhile,the surgeons need proficient laparoscopic surgery skills.

关 键 词：胆总管囊肿 腹腔镜检查 改良三孔法 常规四孔法 儿童 对比研究 

分 类 号：R657.4[医药卫生—外科学]