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儿童胆总管囊肿的腹腔镜治疗:从中低收入国家汲取的经验教训

Laparoscopic management of choledochal cyst in children: Lessons learnt from low-middle income countries.

作者信息

Liem Nguyen Thanh, Agrawal Vikesh, Aison Dexter S

机构信息

Department of Pediatric Surgery, National Children Hospital, Hanoi; Department of Pediatric Surgery, Vinmec Research Institute of Stemcell and Gene Technology, Hà Nôi, Vietnam.

Department of Surgery, Division of Pediatric Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India.

出版信息

J Minim Access Surg. 2021 Jul-Sep;17(3):279-286. doi: 10.4103/jmas.JMAS_114_20.

Abstract

Choledochal cyst (CC) is a disease with a strong Asian preponderance. As laparoscopic surgery has become mainstay in its treatment, the experience in these countries has been phenomenal. However, there are many contentious issues related with the laparoscopic management of CC. In this review article, we will try to answer the contentious questions related to the laparoscopic management of CC. The issues related to aetiology, classification, surgical technique, type of biliary anastomosis, intrahepatic stones and malignancy are discussed. We also discuss the current and future considerations of laparoscopic management with reference to it becoming a gold standard. This article describes the standard surgical approach and will discuss its technical nuances. This article will also discuss the outcome of treatment in different settings of low- and middle-income countries based on lessons learnt by the authors from their experience and research.

摘要

胆总管囊肿(CC)是一种在亚洲发病率极高的疾病。随着腹腔镜手术成为其主要治疗手段,亚洲国家在这方面积累了丰富的经验。然而,CC的腹腔镜治疗仍存在许多争议性问题。在这篇综述文章中,我们将尝试解答与CC腹腔镜治疗相关的争议性问题。文章讨论了病因、分类、手术技术、胆肠吻合类型、肝内结石及恶变等相关问题。我们还参照腹腔镜治疗成为金标准的情况,探讨了其当前及未来的考量因素。本文描述了标准手术入路,并将讨论其技术细节。本文还将基于作者从自身经验及研究中获得的经验教训,探讨低收入和中等收入国家不同情况下的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566a/8270031/41a91988a938/JMAS-17-279-g001.jpg

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