腹腔镜改良Kasai手术与传统开放Kasai手术治疗小儿胆道闭锁的对比研究  

Comparative study of laparoscopic-modified Kasai versus conventional open Kasai for biliary atresia in infants

作　　者：朱世春 刘振勇 李炳[2] ZHU Shichun;LIU Zhenyong;LI Bing(Department of Pediatric Surgery,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China;Department of Pediatric Surgery,Huai'an Women and Children's Hospital)

机构地区：[1]扬州大学附属医院小儿外科,江苏扬州225000 [2]江苏省淮安市妇幼保健院、淮安市儿童医院小儿外科

出　　处：《腹腔镜外科杂志》2023年第11期855-858,866,共5页Journal of Laparoscopic Surgery

基　　金：江苏省妇幼健康科研项目(F201713);淮安市科技计划项目(HAP202001)。

摘　　要：目的:比较腹腔镜改良Kasai手术与传统开放Kasai手术治疗小儿胆道闭锁的临床疗效。方法:将2015年1月至2021年7月56例接受腹腔镜改良Kasai手术治疗的Ⅲ型胆道闭锁患儿作为改良组,将2012年1月至2016年1月45例采用开放Kasai手术治疗的Ⅲ型胆道闭锁患儿作为对照组。回顾分析两组患儿临床资料。结果:两组患儿性别、年龄、体重及术后住院时间差异均无统计学意义。改良组与对照组术中失血量[(11.2±5.5)mL vs.(22.5±7.5)mL,P<0.05]、手术时间[(235.5±20.5)min vs.(180.5±25.5)min,P<0.05]、术后进食时间[(2.3±1.5)d vs.(4.5±1.6)d,P<0.05]差异有统计学意义。改良组与对照组黄疸清除率分别为78.6%与60.0%,原肝存活率分别为71.4%与51.1%,差异均有统计学意义(P<0.05)。结论:与开放Kasai手术相比,腹腔镜改良Kasai手术可改善胆道闭锁患儿的预后,具有临床应用价值。Objective:To compare the clinical efficacy of laparoscopic modified Kasai portoenterostomy and traditional open Kasai portoenterostomy in the treatment of pediatric biliary atresia.Methods:A total of 56 children with typeⅢbiliary atresia who u nderwent laparoscopic modified Kasai portoenterostomy from Jan.2015 to Jul.2021 were selected as the improved group,and 45 children with biliary atresia treated with open Kasai portoenterostomy from Jan.2012 to Jan.2016 were selected as the control group.The clinical data between the two groups were retrospectively analyzed.Results:There were no significant differences in gender,age,body weight and postoperative hospital stay between the improved group and the control group.There were significant differences in blood loss[(11.2±5.5)mL vs.(22.5±7.5)mL,P<0.05],operation time[(235.5±20.5)min vs.(180.5±25.5)min,P<0.05]and post-o perative feeding time[(2.3±1.5)d vs.(4.5±1.6)d,P<0.05]between the improved group and the control group.The jaundice clearance rate of the improved group and the control group was 78.6%and 60.0%,respectively,and the survival rate of the native liver in the two groups was 71.4%and 51.1%,respectively,there were statistical differences between the two groups.Conclusions:C ompared with open Kasai portoenterostomy,laparoscopic modified Kasai portoenterostomy can improve the prognosis of children with biliary atresia,and has clinical application value.

关 键 词：胆道闭锁 胆管肠吻合术 肝 腹腔镜检查 儿童 对比研究 

分 类 号：R657.4[医药卫生—外科学]