Aspelund Gudrun, Ling Simon C, Ng Vicky, Kim Peter C W
Division of General Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
J Pediatr Surg. 2007 May;42(5):869-72. doi: 10.1016/j.jpedsurg.2006.12.052.
BACKGROUND/PURPOSE: Indications for a laparoscopic approach in the management of biliary atresia and choledochal cysts in children are not clearly defined. We present our initial experience with 9 consecutive laparoscopic cases, and compare them to the traditional open approach.
A retrospective comparison of all consecutive operations for biliary atresia and choledochal cysts from January 2000 to May 2006 was undertaken. We evaluated the patient's age at operation, operative time, return of bowel function postoperatively, length of hospital stay, complications, and the need for subsequent liver transplantation. Mann-Whitney U test was used for statistical analysis.
A total of 45 portoenterostomies and choledochojejunostomies were performed, including 9 laparoscopic and 36 open procedures. Patients with choledochal cysts were older than patients with biliary atresia. All the compared parameters were similar and there was no difference in outcomes between the laparoscopic and the open groups.
Our initial experience is encouraging and indicates that the laparoscopic approach is technically feasible, safe, and effective, with a low morbidity and a comparable outcome to the open technique. Longer follow-up of a larger patient cohort is needed.
背景/目的：儿童胆道闭锁和胆总管囊肿治疗中腹腔镜手术方法的适应证尚无明确定义。我们介绍了连续9例腹腔镜手术的初步经验，并将其与传统开放手术方法进行比较。
对2000年1月至2006年5月期间所有连续进行的胆道闭锁和胆总管囊肿手术进行回顾性比较。我们评估了患者的手术年龄、手术时间、术后肠功能恢复情况、住院时间、并发症以及后续肝移植的需求。采用曼-惠特尼U检验进行统计分析。
共进行了45例肝门空肠吻合术和胆总管空肠吻合术，其中包括9例腹腔镜手术和36例开放手术。胆总管囊肿患者比胆道闭锁患者年龄大。所有比较的参数相似，腹腔镜组和开放组的结果无差异。
我们的初步经验令人鼓舞，表明腹腔镜手术方法在技术上可行、安全且有效，发病率低，与开放技术的结果相当。需要对更大的患者队列进行更长时间的随访。
