胆总管囊肿切除术后胆肠吻合口狭窄的腹腔镜手术处理OACSTPCD

Objective To summarize the effect of laparoscopic management of biliary-enteric anastomotic stricture after choledochal cyst resection.Methods A retrospective analysis was performed on patients with biliary-enteric anastomotic stricture after choledochal cyst resection and then received laparoscopic choledochal anastomotic reconstruction between Jul.2019 and Apr.2024.The laparoscopic reconstruction procedure was divided into three parts:the anatomical resetting of the relevant organs,the establishment of large-diameter bile duct opening and stone extraction,the reconstruction of biliary enterostomy and enterostomy.Operation time,blood loss,anal exhaust time,postoperative hospitalization time and postoperative complications of these patients were analyzed.Results The clinical data of 13 cases was collected in this study.The first case underwent laparotomy surgery and the other 12 cases underwent laparoscopy surgery.The operation time was 3.5-5.0 h,with an average of(4.1±0.6)h.The amount of blood loss was 20-150 mL,with an average of(61.5±41.4)mL.The postoperative anal exhaust time was 2-4 d,with an average of(2.5±0.7)d,The postoperative hospitalization time was 7-12 d,with an average of(8.8±1.9)d.There was no postoperative abdominal infection,abdominal hemorrhage,reoperation or postoperative death case.All 13 cases were followed-up for 9-57 months,with an average of(32.3±15.1)months.No case of recurrent biliary-enteric anastomotic stricture was found during the follow-up;one patient was found with cholangitis symptom,who relieved by conservative treatment.Conclusion For patients with biliary-enteric anastomotic stricture after choledochal cyst resection,laparoscopic reconstruction is safe and effective.