临床小儿外科杂志2025，Vol.24Issue(3)：231-235,5.DOI:10.3760/cma.j.cn101785-202405073-006
完全腹腔镜与开放Kasai手术治疗Ⅲ型胆道闭锁的对比研究
A comparative study of total laparoscopic versus open Kasai portoenterostomy for type Ⅲ biliary atresia
摘要
Abstract
Objective To compare the efficacy of total laparoscopic versus open Kasai portoenterostomy for type Ⅲ biliary atresia(BA).Methods From May 2020 to December 2021,the relevant clinical data were retrospectively reviewed for 14 children undergoing laparoscopic Kasai portoenterostomy and 66 cases undergo-ing open Kasai portoenterostomy.Two groups were compared with regards to gender,operative age,body weight,preoperative total bilirubin,direct bilirubin,alanine aminotransferase,gamma-glutamyl transferase,aspartate aminotransferase-to-platelet ratio index,operative duration,volume of blood loss,time of feeding recovery,post-operative hospitalization stay,postoperative complications(biliary fistula,intestinal fistula,intestinal obstruction& wound dehiscence),postoperative cholangitis rate,early cholangitis rate,frequent cholangitis rate,jaundice clearance rate,1/2-year survival rate of native liver(SNL)and survival rate.Results There was statistically significant inter-group difference(P＜0.05)in operative duration[213(205,243)vs.168(150,190)min].No statistically significant difference(P＞0.05)existed in volume of blood loss[10(5,10)vs.10(10,10)mL],time of feeding recovery[6.8(5.5,7)vs.6.8(6.5,7)day],postoperative hospitalization stay[15(14,17)vs.15(14,16)day],postoperative cholangitis rate(71.4％vs.48.5％),early cholangitis rate(28.6％vs.19.7％),frequent cholangitis rate(14.3％vs.15.2％),jaundice clearance rate(71.4％vs.69.7％),1-year SNL(57.1％vs.75.8％),2-year SNL(57.1％vs.71.2％),1-year survival rate(78.6％vs.84.8％)and 2-year survival rate(78.6％vs.81.8％).Conclusions Total laparoscopic Kasai portoenterostomy is safe,feasible and mini-invasive.Its outcomes are superior to those of open surgery.关键词
腹腔镜/胆道闭锁/外科手术/儿童Key words
Laparoscopy/Biliary Atresia/Surgical Procedures,Operative/Child引用本文复制引用
冯勇,周崇高,夏仁鹏,邹婵娟,许光,董洁,李波..完全腹腔镜与开放Kasai手术治疗Ⅲ型胆道闭锁的对比研究[J].临床小儿外科杂志,2025,24(3):231-235,5.基金项目
国家临床重点专科重大科研专项(Z20230059) （Z20230059）
湖南省出生缺陷协同防治科技重大专项(2019SK1010) （2019SK1010）
湖南省自然科学基金(2025JJ50672) Major Scientific Special Project for National Key Clinical Specialty(Z20230059) （2025JJ50672）
Hunan Province Birth Defect Collaborative Prevention and Control Technology Major Project(2019SK1010) （2019SK1010）
Hunan Provincial Natural Science Foundation of China(2025JJ50672) （2025JJ50672）
