Diao Mei, Li Long, Cheng Wei
Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
J Laparoendosc Adv Surg Tech A. 2012 Jul-Aug;22(6):615-20. doi: 10.1089/lap.2011.0518. Epub 2012 Jun 12.
BACKGROUND/PURPOSE: Single-incision laparoscopic surgery aims to minimize surgical trauma. Yet there has been no report on its application to the treatment of correctable biliary atresia (BA). We present here our initial mini-series of successful single-incision laparoscopic hepaticojejunostomy (SILH) for correctable BA.
We reviewed 4 correctable BA patients (Type I/II, 3/1) who underwent SILH between May and July 2011. Ultrasonography, upper gastrointestinal contrast studies, and blood tests were performed during the follow-up period. The age at operation, operative time, postoperative hospital stay, resumption of full diet, postoperative complications, and perioperative laboratory tests were evaluated.
The median age at operation was 21 days. The median operative time was 2 hours. Blood loss was minimal. The median follow-up duration was 4.5 months. Jaundice gradually declined after 3-5 days in Type I and 6 days in Type II BA patient. There was no mortality or surgical complication so far.
In experienced hands, SILH for treatment of correctable BA is safe and effective.
背景/目的：单切口腹腔镜手术旨在将手术创伤降至最低。然而，尚无关于其应用于可矫治性胆道闭锁（BA）治疗的报道。在此，我们展示了我们最初的一组成功应用单切口腹腔镜肝空肠吻合术（SILH）治疗可矫治性BA的病例。
我们回顾了2011年5月至7月间接受SILH手术的4例可矫治性BA患者（I/II型，3/1）。随访期间进行了超声检查、上消化道造影检查及血液检查。评估了手术年龄、手术时间、术后住院时间、恢复正常饮食情况、术后并发症及围手术期实验室检查结果。
手术时的中位年龄为21天。中位手术时间为2小时。出血量极少。中位随访时间为4.5个月。I型BA患者在术后3 - 5天黄疸逐渐消退，II型BA患者在术后6天黄疸逐渐消退。目前无死亡病例或手术并发症。
在经验丰富的医生操作下，SILH治疗可矫治性BA安全有效。
