Alizai Naved K, Dawrant Michael J, Najmaldin Azad S
Children's Liver Unit*, Department of Paediatric Surgery, Leeds Children's Hospital, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK,
Pediatr Surg Int. 2014 Mar;30(3):291-4. doi: 10.1007/s00383-013-3459-5. Epub 2014 Jan 24.
Choledochal cysts have traditionally been treated as an open procedure. However, recent publications from some large volume centres show that minimally invasive surgery has become their standard approach. Robotic surgical systems facilitate a surgeon's ability to undertake complex procedures. We present our experience of using robot assistance to treat choledochal cysts.
Children admitted with a choledochal cyst from March 2009 to Nov 2012 were included. There were 27 patients (20 females). Mean age 5.4 years (range 0.3-15.9). Mean weight 21.9 kg (range 5.9-78.8); 10 weighed <10 kg. The choledochal cysts were types 1c(12), 1f(10) and 4(5). The da vinci Surgical System was used for the robot-assisted resection of the choledochal cyst and hepaticojejunostomy. Roux loop was fashioned extra-corporeally. Mean follow-up is 2.7 years (range 0.9-4.7).
22 cases were completed successfully with robotic assistance. Five open conversions were for anatomical concerns or technical reasons. One child had three complications (omental hernia, anastomotic stricture and subsequent bile leak). Patients were on full feeds by a median of 5 days (range 3-6) and discharged after 6 days (range 4-7).
Robotic-assisted resection of choledochal cysts in children is safe. They made a rapid recovery with a good cosmetic outcome.
胆总管囊肿传统上采用开放手术治疗。然而，一些大容量中心最近发表的文章表明，微创手术已成为其标准治疗方法。机器人手术系统有助于外科医生进行复杂手术。我们介绍我们使用机器人辅助治疗胆总管囊肿的经验。
纳入2009年3月至2012年11月因胆总管囊肿入院的儿童。共27例患者（20例女性）。平均年龄5.4岁（范围0.3 - 15.9岁）。平均体重21.9千克（范围5.9 - 78.8千克）；10例体重<10千克。胆总管囊肿类型为1c（12例）、1f（10例）和4型（5例）。使用达芬奇手术系统进行机器人辅助胆总管囊肿切除术和肝空肠吻合术。Roux袢在体外制作。平均随访2.7年（范围0.9 - 4.7年）。
22例在机器人辅助下成功完成手术。5例转为开放手术是出于解剖学考虑或技术原因。1名儿童出现3种并发症（网膜疝、吻合口狭窄及随后的胆漏）。患者术后中位5天（范围3 - 6天）开始全量喂养，6天（范围4 - 7天）出院。
机器人辅助儿童胆总管囊肿切除术是安全的。患者恢复快，美容效果好。
