摘要
目的:探讨腹腔镜与开腹手术治疗胆总管囊肿的临床疗效与安全性。方法:先天性胆总管囊肿患儿98例随机分为腹腔镜组(腹腔镜下切除囊肿)和开腹组(开腹手术切除囊肿),观察两组手术时间、术中出血量、术后排气时间、进食时间以及住院时间差异,并记录并发症。结果:两组均未发生围术期死亡病例。腹腔镜组有1例因粘连较重,中转开腹手术;开腹组患儿均顺利完成手术。腹腔镜组手术时间长于开腹组,但术中出血少于开腹组,术后排气时间、进食时间及住院时间均短于开腹组(P<0.01)。两组术后主要并发症为胆漏、胰瘘等,并发症发生率无统计学意义(P>0.05)。结论:与开腹手术比较,经腹腔镜治疗胆总管囊肿耗时较长,但创伤小,术后恢复快,且不增加并发症的发生,临床应根据患者实际情况选择术式,提高临床受益。
Objective： To explore the clinical efficacy and safety of laparoscope and laparotomy in the treatment of choledochocyst. Methods： A total of 98 infants with congenital choledochocyst were randomly divided into laparoscope group treated with laparoscope and laparotomy group with laparotomy to incise the cyst. The differences of surgical duration,intra-operative hemorrhagic volume,postoperative evacuation time,feeding time and hospital stays between two groups were observed and complications were recorded. Results： Both group had no intra-operative death. Only 1 infant in laparoscope group was transferred to laparotomy due to severe adhesion,whereas all infants in laparotomy group finished the surgery successfully. Laparoscope group was evidently longer in surgical duration but significantly lower in intra-operative hemorrhagic volume and markedly shorter in postoperative evacuation time,feeding time and hospital stays than laparotomy group（ P〈0. 01）. Bile leakage and pancreatic fistula were the primary complications in both groups,but there was no significant difference between two groups in the rate of complications（ P〈0. 05）. Conclusion： Compared with laparomoty,laparoscope is longer in surgical duration but smaller in trauma and quicker in postoperative recovery without increasing the development of complications in treating choledochocyst,so selection of proper surgical method based on the real conditions of patients can improve their clinical benefits.
出处
《川北医学院学报》
CAS
2015年第6期838-840,共3页
Journal of North Sichuan Medical College
