腹腔镜外科杂志2024，Vol.29Issue(7)：508-512,516,6.DOI:10.13499/j.cnki.fqjwkzz.2024.07.508
腹腔镜联合胆道镜治疗儿童先天性胆管扩张症的临床应用
Clinical application of laparoscopy combined with choledochoscopy for children with congenital biliary dilatation
潘祝彬 1张涛 1戚士芹 1周玉良 1张振强 1琚俊俊 1沈伟臣1
作者信息
- 1. 安徽省儿童医院普通外科,安徽 合肥,230000
- 折叠
摘要
Abstract
Objective:To investigate the clinical effect of laparoscopy combined with choledochoscopy in the surgical treatment of congenital biliary dilatation in children.Methods:The clinical data of 98 children with congenital biliary dilatation who underwent laparoscopic radical surgery from Dec.2019 to Dec.2023 were collected and divided into three groups based on the intraoperative biliary examination methods.The laparoscopic group(n=38)only underwent laparoscopic surgery,the cholangiography group(n=28)under-went intraoperative cholangiography in laparoscopic surgery,and the choledochoscopy group(n=32)underwent choledochoscopy in laparoscopic surgery.All children underwent routine magnetic resonance cholangiopancreatography before surgery.The collected data included gender,age,cyst type,cyst diameter,cyst length,presence of stones and bile duct abnormalities detected in preoperative mag-netic resonance cholangiopancreatography,identification of new stones during surgery,bile duct variations,bile duct stenosis,postopera-tive bile leakage,cholangitis,pancreatitis,and anastomotic stenosis.Results:There were no significant differences in gender,age,cyst diameter,cyst length,cyst type,stones and biliary tract abnormalities found by preoperative magnetic resonance cholangiopancreatogra-phy among the three groups(P＞0.05).The choledochoscopy group found more new stones(28.1%,9/32),the cholangiography group detected more biliary variations(21.4%,6/28),the differences were statistically significant(P＜0.05).The total complication rate differed among the three groups(P＜0.05),the choledochoscopy group had the lowest postoperative complication rate(3.1%,1/32).Conclusions:Laparoscopy combined with choledochoscopy can detect more"missed"stones with lower postoperative complication rates,while avoiding the risk of radiation exposure in children,which is worthy of further application in clinical practice.关键词
先天性胆管扩张症/腹腔镜检查/胆道镜检查/胆管造影术/儿童Key words
Congenital biliary dilatation/Laparoscopy/Choledochoscopy/Cholangiography/Child分类
医药卫生引用本文复制引用
潘祝彬,张涛,戚士芹,周玉良,张振强,琚俊俊,沈伟臣..腹腔镜联合胆道镜治疗儿童先天性胆管扩张症的临床应用[J].腹腔镜外科杂志,2024,29(7):508-512,516,6.
