临床小儿外科杂志2025，Vol.24Issue(4)：331-338,8.DOI:10.3760/cma.j.cn101785-202307044-006
经脐单孔与传统四孔法腹腔镜手术治疗儿童胆总管囊肿的对比研究
Clinical comparison of transumbilical single-port laparoscopic versus conventional four-port laparo-scopic treatment of pediatric choledochal cyst
摘要
Abstract
Objective To compare clinical application value of transumbilical single-port laparoscopic hepaticojejunostomy(TUSPLH)versus conventional four-port laparoscopic hepaticojejunostomy(CLH)for children with choledochal cyst using conventional laparoscopic instruments.Methods From June 2019 to De-cember 2022,87 children with choledochal cyst were hospitalized.According to the inclusion criteria,the clini-cal data of 85 children were retrospectively reviewed.Forty-four children underwent TUSPLH while another 41 children CLH.Baseline profiles,operative findings and curative outcomes were compared between two groups.Results All operation were successfully completed.Age[(54.7±22.2)vs.(49.7±20.0)month,t=1.087,P=0.280],volume of blood loss[(5.4±1.1)vs.(5.8±1.5)mL,t=-1.544,P=0.126],drain-age tubing rate[19.5％(8/41)vs.11.4％(5/44),x2=1.088,P=0.297],intestinal function recovery time[(15.9±5.8)vs.(17.8±6.3)h,t=-1.446,P=0.152],postoperative hospital stay[(7.3±2.1)vs.(6.9±1.6)day,t=1.086,P=0.281]and complication rate[2.4％(1/41)vs.2.3％(1/44),P=1.000]showed no significant inter-group difference.The inter-group differences in operative duration[(195.7±41.4)vs.(255.4±53.9)min,t=-5.693,P＜0.001],pain score[(4.0±1.4)vs.(3.3±1.0),t=2.826,P=10.006]and incision healing satisfaction score[(8.5±0.7)vs.(9.3±0.4),t=-6.365,P＜0.001]differed significantly.One child in TUSPLH group experienced postoperative bile leakage and healed after 12-day abdominal drainage.Another child in CLH group had postoperative hemorrhage.Emergency laparoscopic ex-ploration revealed hemorrhage of cyst separation surface.After surgical hemostasis,the child recovered smooth-ly.The remainders had no onset of such complications as anastomotic stenosis,cholangitis or pancreatitis.No mortality occurred in neither groups.Conclusions For pediatric choledochal cyst,both TUSPLH and CLH with conventional laparoscopic instruments may achieve similar short/middle-term outcomes.The former offers a satisfactory cosmetic incision and milder postoperative pain.However,there are greater surgical difficulty and longer operative duration.For recurrent preoperative biliary tract infections and imaging findings necessitating intraoperative cholangioplasty,TUSPLH should be performed with more caution.关键词
胆总管囊肿/外科手术,方法/腹腔镜检查/治疗结果/对比研究/儿童Key words
Choledochal Cyst/Surgical Procedures,Operative,Methods/Laparoscopy/Treatment Out-come/Comparative Study/Child引用本文复制引用
陶波圆,钟知足,曾纪晓,刘斐,徐晓钢,兰梦龙,梁子建..经脐单孔与传统四孔法腹腔镜手术治疗儿童胆总管囊肿的对比研究[J].临床小儿外科杂志,2025,24(4):331-338,8.基金项目
国家自然科学基金(82170528) （82170528）
广东省自然科学基金(2022A1515012254) （2022A1515012254）
广州市科技计划市校(院)联合资助项目(202201020612) （院）
广州市临床特色技术项目(2023C-TS48) National Natural Science Foundation of China(82170528) （2023C-TS48）
Natural Science Foundation of Guangdong Province(2022A1515012254) （2022A1515012254）
Guangzhou Municipal Science & Technology Plan Municipal U-niversity(Institute)Joint Project(202201020612) （Institute）
Guangzhou Municipal Project of Clinical Characteristic Technology(2023C-TS48) （2023C-TS48）
