摘要
目的探讨腹腔镜保胆取石治疗小儿胆囊结石的安全性和有效性。方法回顾性分析2010年7月至2016年12月大连医科大学附属大连市儿童医院经腹腔镜保胆取石术治疗小儿胆囊结石18例的临床资料，其中男8例，女10例；年龄5-14岁[（9.2±3.1）岁]；胆囊单发结石11例，多发结石7例。患儿均接受3-72个月的随访。结果18例患儿均经彩色多普勒超声及磁共振胰胆管成像（MRCP）检查确诊，无胰胆管合流异常，术前行胆囊收缩功能评估，结果均良好。所有患儿顺利完成手术，无中转行胆囊切除术。手术时间为28-66 min[（40.2±14.3） min]；出血量4-12 mL[（8.3±2.8） mL]；术后住院3-5 d [（3.8±1.2） d]；治疗期间未发生胆漏、术后出血、胆管损伤、胆源性胰腺炎及其他并发症。随访3-72个月，彩色多普勒超声检查均未发现胆囊结石复发。结论对于胆囊功能良好的患儿，腹腔镜保胆取石治疗小儿胆囊结石可保留胆囊功能及胆道的完整性，操作简单、创伤小、恢复快、复发率低、手术确切可靠，是治疗小儿胆囊结石的可行性方法。
Objective To investigate the safety and efficiency of laparoscopic gallbladder-preserving cholelithotomy in the treatment of cholecystolithiasis in children.Methods The clinical data obtained from 18 children with gallstones undergoing laparoscopic gallbladder-preserving cholelithotomy at Dalian Children′s Hospital of Dalian Medical University during July 2010 and December 2016 were retrospectively analyzed.Eight boys and 10 girls of 5-14 years old [mean （9.2±3.1） years old] were included in the study, of whom 11 cases had a single stone, 7 cases with multiple stones.All patients were followed up for 3-72 months.Results All of 18 patients without pancreaticobiliary maljunction were diagnosed by Color Doppler ultrasound and magnetic resonance cholangiopancreatography（MRCP）. Gallbladder functions were assessed preoperatively and they were all in good condition.Laparoscopic gallbladder-preserving cholelithotomy was successfully performed in all patients without conversion to cholecystectomy.Operation time was 28-66 min, with mean value of （40.2±14.3） min; intraoperative blood loss was 4-12 mL, with mean value of （8.3±2.8） mL; postoperative hospital stay lasted 3-5 d, with mean value of （3.8±1.2） d. There were no complications such as bile leakage, postoperative bleeding, biliary duct damage, biliary pancreatitis during therapy.The patients were followed up for 3-72 months, and the Color Doppler ultrasound showed no gallstone recurrence after surgery.Conclusions For children with good gallbladder function, laparoscopic gallbladder-preserving cholelithotomy can preserve gallbladder function and the integrity of biliary tract.The operation is easy and reliable, with minimal invasion, quick recovery, and low recurrence rate.It is a feasible method for the treatment of gallstones in children.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2017年第23期1790-1792,共3页
Chinese Journal of Applied Clinical Pediatrics
关键词
胆囊结石病
保胆取石术
腹腔镜检查
儿童
Cholecystolithiasis
Gallbladder - preserving cholelithotomy
Laparoscopy
Child
