腹腔镜下胆总管囊肿根治切除及胆道重建术

目的探讨腹腔镜下行胆总管囊肿根治切除及胆道重建术的可行性。方法全身麻醉后腹腔镜辅助下按悬吊肝圆韧带、游离胆囊、术中胆道造影、游离切除囊肿、空肠Roux-Y吻合、肝管空肠吻合、缝合系膜裂孔、放置腹腔引流的步骤完成手术。结果 18例患者腹腔镜下顺利根治切除胆总管囊肿,15例经结肠后、3例经结肠前吻合胆道重建术,手术时间3.5～6.5h,2例术后出现并发症。结论经腹腔镜胆总管囊肿根治切除及胆道重建手术安全可靠,值得临床进一步推广应用。

Laparoscope-assisted resection of choledochal cyst and biliary reconstruction

Objective To study the feasibility of complete resection of choledochal cyst with biliary reconstruction laparoscopically. Methods Under laparoscopic guidance,the total cystic excision and Roux-en-Y hepaticojejunostomy then was underwent. Results The whole procedure was accomplished in 18 patients successfully, the anastomosed hepatiojejunal limb was lifted through an incision at the right side of the mesocolon in 15 cases and across the anterior of the colon in 3 cases. The duration of the procedure ranged from 3.5 to 6.5 hours. Conclusions Laparoscopieally assisted resection of the choledochal cyst and hepaticojejunostomy are technically safe and feasible procedure, and deserve further clinical practices.