改良Warren吻合术与Roux-en-Y吻合术在小儿腹腔镜胆总管囊肿术中的临床对照研究  

Clinical comparative study of modified Warren anastomosis and Roux-en-Y anastomosis in laparoscopic choledochus cyst surgery in children

作　　者：马仲福 赵成基 曾永娟 陈亚惊 胡继科 李斌德[1] 李刚[1] 王文赟[1] 杨爱玲[1] Ma Zhongfu;Zhao Chengji;Zeng Yongjuan;Chen Yajing;Hu Jike;Li Binde;Li Gang;Wang Wenyun;Yang Ailing(Department of Pediatric Surgery,The Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院小儿外科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2023年第9期52-56,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：兰州大学教育发展基金会捐赠类科研资助项目(2021620005003631)。

摘　　要：目的比较腹腔镜先天性胆总管囊肿根治术中2种胆肠吻合方式的优劣,为临床选择不同术式提供理论依据。方法回顾性分析兰州大学第二医院2016年7月-2022年4月收治的117例先天性胆总管囊肿患者,按手术方式分为Roux-en-Y吻合组(63例)与改良Warren吻合组(54例)。2组患者均行腹腔镜下胆总管囊肿根治性切除术,肠-肠吻合方式有Roux-en-Y式肠-肠吻合及改良Warren式肠-肠吻合。比较2组患者手术效果、术后效果及术后并发症等指标。结果2组患者手术时间、吻合时间、术后恢复排气排便时间、术后并发肠梗阻及反流性胆管炎方面差异均有统计学意义(P<0.05),而其余指标没有显示明显差异(P>0.05)。结论改良Warren吻合术较Roux-en-Y吻合术,具有手术时间短、吻合快、术后肠功能恢复快、防反流效果好等优点,且操作简便,不切断肠管,保证肠管电生理活动的连续性,适合在基层医院推广。Objective To compare the advantages and disadvantages of two types of biliary intestinal anastomosis methods in laparoscopic radical surgery for congenital choledochal cysts,providing a theoretical basis for clinical doctors to choose different surgical methods.Methods 117 children with congenital choledochus cyst treated in The Second Hospital of Lanzhou University from July 2016 to April 2022 were analyzed,and the cases were divided into a Roux-en-Y anastomosis group(63 cases)and a modified Warren anastomosis group(54 cases)according to different surgical methods.Laparoscopic radical resection of choledochus cyst was performed in both,with Roux-en-Y enterostomy and modified Warren enterostomy.The operative and postoperative effects and postoperative complications were compared between them.Results There were statistically significant differences between the two groups in operation time,anastomotic time,time to recover exhaust and defecation,postoperative complications of bowel obstruction and reflux cholangitis(P<0.05),but no significant differences in other indicators(P>0.05).Conclusions Compared with Roux-en-Y anastomosis,the modified Warren anastomosis has advantages such as a shorter surgical time,faster anastomosis,faster postoperative intestinal function recovery and better anti reflux effect.At the same time,it is simple to operate,does not break the intestinal tube and ensures the continuity of intestinal electrophysiological activities,thus being more suitable for promotion and use in grassroots hospitals.

关 键 词：ROUX-EN-Y吻合术 改良Warren吻合术 小儿腹腔镜手术 先天性胆总管囊肿 

分 类 号：R726.1[医药卫生—儿科]