Wake Forest School of Medicine, General Surgery, Winston-Salem, NC, United States.
Wake Forest School of Medicine, Pediatric Surgery, Winston-Salem, NC, United States.
J Pediatr Surg. 2021 Apr;56(4):825-828. doi: 10.1016/j.jpedsurg.2020.12.001. Epub 2020 Dec 13.
The management of choledocholithiasis in children and teenagers is often a two-procedure process with laparoscopic cholecystectomy (LC) and either pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP). The addition of laparoscopic common bile duct exploration (LCBDE) during LC can provide definitive treatment for choledocholithiasis during a single anesthetic event. In an effort to minimize sedation and radiation exposure from fluoroscopy, we have employed dilating balloons via a transcystic approach to stretch the sphincter of Oddi with subsequent ductal flushing. We describe the technique of balloon sphincteroplasty as a straightforward adjunct within the pediatric surgeon's skill set to manage choledocholithiasis during LC and our clinical experience.
儿童和青少年胆总管结石的治疗通常采用两阶段手术，即腹腔镜胆囊切除术（LC）联合术前或术后经内镜逆行胰胆管造影术（ERCP）。LC 时行腹腔镜胆总管探查术（LCBDE）可在单次麻醉事件中为胆总管结石提供确定性治疗。为了尽量减少镇静和透视放射暴露，我们采用经胆囊管入路扩张球囊来扩张 Oddi 括约肌，随后进行胆管冲洗。我们描述了球囊括约肌成形术作为一种在小儿外科医生技能范围内的简单辅助手段，用于治疗 LC 时的胆总管结石，并介绍了我们的临床经验。
