腹腔镜下胆总管囊肿的手术治疗

目的 探讨在腹腔镜下胆总管囊肿切除、空肠切断及肠肠吻合、胆总管空肠Roux-en-Y吻合的可行性、安全性、技术特点及优势.方法 自2008年6月至2013年2月期间,对24例胆管囊肿行腹腔镜下病变胆管切除、空肠切断及肠肠吻合、胆总管空肠Roux-en-Y吻合.结果 24例患者均顺利完成手术.手术时间168 ～216 min,平均（168±24） min.术中出血40～ 120 ml,平均（60±33）ml.术后出现胆漏1例,无肠漏、无出血等.结论 腹腔镜下病变胆管切除、肠管切断及肠肠吻合、胆总管空肠Roux-en-Y吻合是安全、可行的,与开腹手术相比,有明显优势.

Laparoscopic surgery for choledochocyst

Objective To discuss the feasibility, safety, features and advantages of choledochocyst excision,jejunum amputation,jejuno-jejunal anastomosis and Roux-en-Y biliary-jejunal anastomosis in lap- aroscopic sugery. Methods From June 2008 to February 2013,24 cases of choledochocyst received chole- docbocyst excision,jejunum amputation,jejuno-jejunal anastomosis and Roux-en-Y biliary-jejunal anasto- mosis. Result All surgeries were succssfully completed. The operation time ranged from 168 to 216 min, with an average of 168 ＋ 24 rain. The volume of intraoperative hemorrhage ranged from 40 to 120 ml, with an average of 60 _＋ 33 ml. There was 1 case of postoperative bile leakage. No intestinal leakage or bleeding occured. Conclusion Bile lesion excision,jejunum amputation,jejuno-jejunal anastomosis and Roux-en-Y biliary-jejunal anastomosis under the laparoseope are safe and effective. Compared with the traditional open operation, it has obvious advantages.