Diao Mei, Li Long, Cheng Wei
Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China.
Pediatr Surg Int. 2013 Apr;29(4):317-26. doi: 10.1007/s00383-013-3266-z. Epub 2013 Jan 31.
Laparoscopy enables surgeons to approach the surgical conditions from a new perspective. Laparoscopic surgery has revolutionized the treatment of choledochal cysts (CDC). Yet, this new technique requires objective evaluations. We have examined the controversies about the CDC dissection, distal common bile duct ligation, ductoplasty for hepatic duct stenosis, intrahepatic duct and common channel protein plug clearance, timing of surgery for antenatally diagnosed CDC, and the Roux loop length in CDC children. In the hands of experts, laparoscopic excision of the cyst and Roux-en-Y hepaticojejunostomy is a safe and effective approach. We provide our opinions on these issues based on our experience and publications. We conclude that the main outcomes comparable to those of the open surgery. The better wound cosmesis and reduction of surgical trauma are the advantages.
腹腔镜检查使外科医生能够从一个全新的视角处理手术情况。腹腔镜手术已经彻底改变了胆总管囊肿(CDC)的治疗方式。然而,这项新技术需要客观评估。我们审视了有关CDC剥离、胆总管远端结扎、肝管狭窄的胆管成形术、肝内胆管和共同通道蛋白栓清除、产前诊断的CDC的手术时机以及CDC患儿的Roux袢长度等方面的争议。在专家手中,腹腔镜下囊肿切除及Roux-en-Y肝空肠吻合术是一种安全有效的方法。我们基于自身经验和相关文献就这些问题发表我们的看法。我们得出结论,主要结果与开放手术相当。伤口美观度更佳以及手术创伤减小是其优势所在。