腹腔镜切除与开放切除治疗胆总管囊肿患儿的效果：中期随访研究。
The effect of laparoscopic excision vs open excision in children with choledochal cyst: a midterm follow-up study.
机构信息
Department of Pediatric Surgery, BaYi Children's Hospital, The military general hospital of Beijing, China.
Department of Pediatric Surgery, the First Hospital, Peking University, Beijing, China.
出版信息
J Pediatr Surg. 2011 Apr;46(4):662-665. doi: 10.1016/j.jpedsurg.2010.10.012.
PURPOSE
Cyst excision with hepaticojejunostomy has been the classic procedure for treating choledochal cysts. Recently, laparoscopic treatment of the disease has gained popularity worldwide. The aim of this study is to evaluate whether laparoscopic management of choledochal cysts is as feasible and safe as conventional open surgery in children with this disease.
METHODS
A retrospective study comparing the laparoscopic and the open procedures was performed in 77 consecutive patients with choledochal cyst in our hospital. Thirty-nine patients operated on between June 2001 and September 2003 were in the laparoscopic group, whereas 38 patients in the open group were operated on between February 1999 and May 2001.
RESULTS
Patient demographics were similar between the 2 groups. The duration of operation was significantly longer in the laparoscopic group than in the open group (median, 230 vs 190 minutes; P < .001). In contrast, the durations of delayed oral feeding and hospital stay postoperatively were significantly shorter in the laparoscopic group (median, 4 vs 5 days [P < .01] and median, 5 vs 7 days [P < .01], respectively.) There were no differences in the early and late complication rates between the 2 groups.
CONCLUSIONS
Laparoscopic treatment of choledochal cyst in children is feasible and safe. For experienced centers, this procedure can be recommended.
目的
胆肠吻合术一直是治疗胆总管囊肿的经典方法。最近，腹腔镜治疗该病在全球范围内得到普及。本研究旨在评估腹腔镜治疗小儿胆总管囊肿是否与传统的开腹手术一样可行和安全。
方法
对我院 77 例胆总管囊肿患儿进行了一项回顾性研究，比较了腹腔镜和开放手术。2001 年 6 月至 2003 年 9 月期间接受手术的 39 例患儿归入腹腔镜组，而 1999 年 2 月至 2001 年 5 月期间接受手术的 38 例患儿归入开放组。
结果
两组患者的人口统计学特征相似。腹腔镜组的手术时间明显长于开放组（中位数分别为 230 分钟和 190 分钟；P<0.001）。相比之下，腹腔镜组术后延迟经口进食和住院的时间明显缩短（中位数分别为 4 天和 5 天[P<0.01]和中位数分别为 5 天和 7 天[P<0.01]）。两组的早期和晚期并发症发生率无差异。
结论
腹腔镜治疗小儿胆总管囊肿是可行且安全的。对于有经验的中心，推荐采用这种方法。
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