胆囊切开取石在合并胆囊结石的遗传性球形红细胞增多症患儿的可行性研究  

Feasibility study of cholecystolithotomy in children with hereditary spherocytosis complicated with gallstones

作　　者：袁俊俊 戚士芹[1] YUAN Jun-jun;QI Shi-qin(The Fifth Clinical School of Medicine,Anhui Children's Hospital,Children's Medical Center of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第五临床医学院,安徽省儿童医院,安徽医科大学儿童医学中心,合肥230000

出　　处：《肝胆外科杂志》2024年第4期274-277,共4页Journal of Hepatobiliary Surgery

摘　　要：目的探索加行胆囊切开取石术在行全脾切除术治疗遗传性球型红细胞增多症(Hereditary spherocytosis,HS)合并胆囊结石患儿的可行性。方法回顾性分析2019年10月至2022年5月我院收治的15例合并有胆囊结石的HS患儿的临床资料和随访结果。15例患儿中男7例,女8例,年龄3~14(8.8±3.4)岁。手术术式均为单孔腹腔镜全脾切除术+胆囊切开取石术,术中用胆道镜取石并确认取尽结石。结果15例患儿均成功手术,术后均恢复顺利。术后7天复查B超:13例无结石,2例有泥沙样结石,经口服熊去氧胆酸治疗,分别术后3月、6月复查超声结石消失。随访至今,所有患儿未出现再发胆囊结石。结论对合并有胆囊结石的HS患儿,全脾切除的同时行胆囊切开取石术是可行的。Objective To explore the feasibility of laparoscopic splenectomy combined with cholecystotomy for the treatment of children with hereditary spherocytosis(HS)and concurrent gallstones.Method The clinical data and follow-up results of 15 children with HS and gallstones admitted to our hospital from October 2019 to May 2022 were retrospectively analyzed.Among the 15 cases,there were 7 males and 8 females,aged between 3-14 years old(mean age:8.8±3.4 years).All surgeries consisted of single-port laparoscopic splenectomy followed by cholecystotomy,during which gallstone removal was confirmed using choledochoscopy.Results All 15 children underwent successful surgery and had smooth postoperative recovery.Follow-up ultrasound examinations conducted at postoperative day seven showed no stones in 13 cases,while two cases had sediment-like stones that disappeared after oral administration of UDCA at three months and six months postoperatively respectively.Until now,none of the patients have experienced recurrent gallstones.Conclusion Simultaneous cholecystotomy during splenectomy is feasible for children with HS who also have gallstones.

关 键 词：胆囊切开取石 胆囊结石 遗传性球形红细胞增多症 儿童 

分 类 号：R657.4[医药卫生—外科学]