摘要
目的探讨外科手术和内镜手术治疗儿童胆总管结石的适应证和临床经验。方法回顾性分析本院2006年9月-2011年3月收集的胆总管结石患儿12例临床资料。男4例,女8例;年龄1岁5个月～15岁,平均7岁。其中单纯外科手术治疗4例,单纯内镜手术治疗5例,外科手术结合内镜治疗3例。结果全组12例均治愈。发生并发症8例,其中外科手术组术后并发胆瘘1例,T管引流0.5 a后痊愈;内镜手术组术后并发高胰岛素血症3例,胰腺炎2例,均保守治疗痊愈;外科手术结合内镜治疗组术后结石残留1例,随访自行排出痊愈。结论内镜手术可以安全应用于儿童胆总管结石的治疗,但必须严格选择适应证,特别需要注意有无合并先天性胆总管扩张症,尽量降低手术并发症发生率。外科手术仍然是治疗该病的主要方法,但应综合考虑治疗风险、预后及费用,以患者利益最大化原则制定最佳治疗方案。
Objective To study the indications and clinical experience of surgery and endoscopic treatment in pediatric choledocholit- hiasis. Methods Retrospective study on 12 pediatric cases with choledocholithiasis from Sep. 2006 to Mar. 2011 was performed. There were 4 cases of male ,and 8 cases of female,their age were from 1 year old and 5 months to 15 years old,the mean age was 7 years old. Surgery was conducted in 4 cases, endoscopic surgery was conducted in 5 cases, surgery and endoscopic treatment were conducted in 3 cases. Results All of these cases were be cured. There were 8 cases had complications, biliary fistula after surgery was in 1 case and be cured though T tube drain 0.5 year; hyperinsulinemia were in 3 cases and pancreatitis were 2 cases after endoscopic treatment, those cases were be cured through medi- cine treatment;remain calculus was in 1 case after surgery combining with endoscopic, the calculus discharged itself in follow - up. Conclu- sions In spite of endoscopic should be conducted safety in pediatric choledocholithiasis, but the indications should be chosen strictly, espe- cially whether the patients had congenital choledochus dilatation or not, and the complications should be reduced. Surgery was major therapy method in this disease. The best treatment plan should be decided according to risk or prognosis and cost.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第7期545-547,共3页
Journal of Applied Clinical Pediatrics
关键词
胆总管结石
外科手术
内镜手术
儿童
choledocholithiasis
surgery
endoscopic surgery
child
