一名患有胆囊胆总管结石的婴儿接受内镜括约肌切开术和腹腔镜胆囊切除术。

Endoscopic sphincterotomy and laparoscopic cholecystectomy in an infant with cholecysto-choledocholithiasis.

作者信息

Sanada Y, Yamaguchi M, Chiba M, Nemoto H, Yoshizawa Y, Hirota Y, Hirata N, Ikeda T, Kumada K

机构信息

Department of Surgery, Showa University, Fujigaoka Hospital, Yokohama, Japan.

出版信息

J Pediatr Surg. 1998 Aug;33(8):1312-4. doi: 10.1016/s0022-3468(98)90177-4.

DOI:10.1016/s0022-3468(98)90177-4

PMID:9722013

Abstract

Laparoscopic cholecystectomy (LC) and endoscopic sphincterotomy (EST) are widely accepted procedures for cholecysto-choledocholithiasis in adults. However, their use in infants has not been reported. An 8-month-old girl presented with high fever and obstructive jaundice. Ultrasound scan showed acute cholecystitis with stones in the bile duct. After 2-week-long antibiotic therapy the acute cholecystitis and hepatic impairment resolved. An endoscopic retrograde cholangiopancreatography (ERCP) confirmed choledocholithiasis and cholecystolithiasis. Risk factors for the development of biliary calculi were not detected. One month after the restoration of her liver function, she underwent EST using a side-viewing endoscope with a small sphincterotome. A common bile duct stone was extracted using a basket catheter. LC was then carried out. The time interval between the EST and LC was 34 days. No complications have been noted for 6 months.

摘要

腹腔镜胆囊切除术（LC）和内镜括约肌切开术（EST）是治疗成人胆囊胆总管结石广泛接受的手术方法。然而，它们在婴儿中的应用尚未见报道。一名8个月大的女孩出现高热和梗阻性黄疸。超声扫描显示急性胆囊炎伴胆管结石。经过为期2周的抗生素治疗，急性胆囊炎和肝功能损害得到缓解。内镜逆行胰胆管造影（ERCP）证实胆总管结石和胆囊结石。未检测到胆石形成的危险因素。肝功能恢复1个月后，她使用带有小型括约肌切开刀的侧视内镜进行了EST。使用篮状导管取出胆总管结石。然后进行了LC。EST和LC之间的时间间隔为34天。6个月来未发现并发症。