完全腹腔镜手术治疗成人先天性胆总管囊肿的临床分析

目的:探讨完全腹腔镜胆总管囊肿切除并肝管空肠Roux-en-Y吻合术治疗成人先天性胆总管囊肿的可行性、安全性及疗效。方法:回顾性分析昆明医科大学第一附属医院2014年5月—2016年5月12例行腹腔镜下胆总管囊肿手术治疗患者的临床资料。结果:11例患者完全腹腔镜下完成胆总管囊肿切除+肝管空肠吻合术,1例为减少手术费用在腹腔外行手工肠肠吻合。手术时间240~310 min,平均280 min;术中出血20~150 m L,平均60 m L;术后住院时间5~7 d,平均6.5 d。术后随访2~12个月,未出现手术并发症,无死亡病例。结论:完全腹腔镜下胆总管囊肿切除+肝管空肠Roux-en-Y吻合术治疗成人先天性胆总管囊肿是安全可行的,且具有明显微创优势,可进一步推广。

Clinical analysis of total laparoscopic surgical treatment of congenital choledochal cysts in adult patients

Objective: To investigate the feasibility, safety and efficacy of total laparoscopic choledochal cyst excision with Roux-en-Y hepatoenterostomy for congenital choledochal cysts in adult patients.Methods: The clinical data of 12 patients who underwent laparoscopic choledochal cysts excision from May 2014 to May 2016 in the First Affiliated Hospital of Kunming Medical University were analyzed retrospectively.Results: Of the patients, total laparoscopic choledochal cyst excision with Roux-en-Y hepatoenterostomy was successfully performed in 11 cases, and one case had extra-abdominal manual enteroenterostomy to reduce surgical cost. The operative time was 240 to 310 min, with an average of 280 min, the intraoperative blood loss was 20 to 150 mL, with an average of 60 mL and the length of postoperative hospital stay was 5 to 7 d, with an average of 6.5 d. Postoperative follow-up was conducted for 2 to 12 months, and no surgical complications or death occurred.Conclusion: Total laparoscopic choledochal cyst excision with Roux-en-Y hepatoenterostomy is safe and feasible in treatment of adult congenital choledochal cysts, and has obvious minimally invasive advantage. So, it is recommended to be used.