Farello G A, Cerofolini A, Rebonato M, Bergamaschi G, Ferrari C, Chiappetta A
Ospedale Civile di Schio, Divisione di Chirurgia Generale, Schio, Italy.
Surg Laparosc Endosc. 1995 Oct;5(5):354-8.
We report our first experience with a laparoscopic treatment of congenital choledochal cysts involving the total cyst resection and the reconstruction of the biliary and gastrointestinal tracts through a transmesocolic hepatic-jejunal Roux-en-Y loop anastomosis. The procedure was carried out in a 14-kg 6-year-old girl with a congenital choledochal cyst of the first type, according to the Alonso-Lej classification. The cyst was divided using a Multifire EndoGIA 30 stapler. Hepatic-jejunal and jejunojejunal anastomoses were made with 4.0 chrome catgut interrupted sutures. Intestinal recanalization occurred on the 2nd postoperative day and the postoperative course was uneventful. The laparoscopic approach affords several advantages: excellent intraoperative visualization of tiny structures and, therefore, great surgical accuracy; early resumption of peristalsis; no postoperative pain; no laparocele; prevention of adhesions; excellent esthetics; and quicker resumption of school and sports activities.
我们报告了首例腹腔镜治疗先天性胆总管囊肿的经验，该手术包括完整囊肿切除，并通过经结肠系膜肝空肠Roux-en-Y袢吻合术重建胆道和胃肠道。手术对象为一名14公斤重的6岁女孩，根据阿隆索-莱伊分类，其患有I型先天性胆总管囊肿。使用Multifire EndoGIA 30吻合器分离囊肿。肝空肠和空肠空肠吻合均采用4.0铬制肠线间断缝合。术后第2天肠道恢复通畅，术后过程顺利。腹腔镜手术方法具有以下几个优点：术中能极好地观察微小结构，从而手术精度高；肠蠕动恢复早；无术后疼痛；无切口疝；预防粘连；美观效果好；能更快恢复上学和体育活动。
