Department of Pediatric Surgery, Children Hospital of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, PR China.
Department of Pediatric Surgery, Children Hospital of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, PR China.
J Pediatr Surg. 2024 Dec;59(12):161689. doi: 10.1016/j.jpedsurg.2024.161689. Epub 2024 Aug 21.
Robotic-assisted Kasai portoenterostomy (RAKPE) has been used to treat biliary atresia (BA). This study aimed to compare the efficacy of RAKPE and open Kasai portoenterostomy (OKPE) for BA.
Thirty-one children with type III BA who underwent surgical treatment in two centers from January 2022 to December 2023 were retrospectively collected. According to the operative techniques, the participants were divided into the RAKPE group (13 cases) and the OKPE group (18 cases). The operative time, jaundice clearance (JC) rate, and incidence of cholangitis were analyzed.
The operative time in the RAKPE group (204.3 ± 19.9 min) was significantly longer than that in the OKPE group (186.2 ± 22.2 min), P < 0.05. However, the blood loss (8.1 ± 2.5 ml) in the RAKPE group was significantly decreased compared with the OKPE group (13.6 ± 4.8 ml), and 15.4% patient need blood transfusion in RAKEP group was litter than that 55.6% in the OKPE group, P < 0.05. The time to oral feeding (2.8 ± 0.4 days vs. 4.3 ± 0.7 days) and the time to pass ICG-positive stools (3.6 ± 0.6 days vs. 4.7 ± 0.9 days) in the RAKPE group were significantly shorter than those in the OKPE group, P < 0.05. No significant differences were observed in the bile excretion rate, hospital stay time, and JC rate. The incidence of cholangitis in the RAKPE group was significantly lower than that in the OKPE group during short follow-up.
RAKPE may be associated with lower intraoperative blood loss, decrease need for postoperative transfusions and decreased rate of postoperative cholangitis compared to OKPE.
III.
机器人辅助Kasai 门腔分流术（RAKPE）已被用于治疗胆道闭锁（BA）。本研究旨在比较 RAKPE 和开腹 Kasai 门腔分流术（OKPE）治疗 BA 的疗效。
回顾性收集 2022 年 1 月至 2023 年 12 月在两个中心接受手术治疗的 31 例 III 型 BA 患儿。根据手术方式将患儿分为 RAKPE 组（13 例）和 OKPE 组（18 例）。分析手术时间、黄疸消退率和胆管炎发生率。
RAKPE 组的手术时间（204.3±19.9 min）明显长于 OKPE 组（186.2±22.2 min），P<0.05。然而，RAKPE 组的出血量（8.1±2.5 ml）明显少于 OKPE 组（13.6±4.8 ml），RAKPE 组 15.4%的患者需要输血，明显少于 OKPE 组的 55.6%，P<0.05。RAKPE 组开始口服喂养的时间（2.8±0.4 天）和 ICG 阳性粪便排出时间（3.6±0.6 天）明显短于 OKPE 组（4.3±0.7 天和 4.7±0.9 天），P<0.05。两组胆汁排泄率、住院时间和黄疸消退率无显著差异。RAKPE 组术后胆管炎发生率明显低于 OKPE 组。
与 OKPE 相比，RAKPE 可能具有术中出血量少、术后输血需求减少和术后胆管炎发生率降低的优点。
III 级。
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