摘要
目的分析儿童腹腔镜胆总管囊肿根治术后并发症的发生情况,并探讨其危险因素。方法2015年8月至2023年6月广州医科大学附属妇女儿童医疗中心胃肠外科六病区共收治胆总管囊肿患儿498例,根据纳入标准对其中464例进行回顾性分析,将其中出现术后并发症的39例患儿作为并发症组,未发生并发症的425例患儿作为无并发症组。采用单因素分析术后并发症发生的影响因素,再通过多因素分析确定影响术后并发症发生的独立危险因素。结果所有患儿均顺利完成手术,464例患儿中,共39例(8.4%)出现术后并发症,其中Clavied-DindoⅠ级7例、Ⅱ级12例、Ⅲ级20例,无Ⅳ级和Ⅴ级并发症发生,以肠梗阻、胆漏和急性胰腺炎发生率较高;并发症组39例中,19例(48.7%)行保守治疗,20例(51.3%)再次手术后痊愈。并发症组与无并发症组在患儿的术时年龄、儿科营养不良评估筛查工具(screening tool for the assessment of malnutrition in pediatrics,STAMP)评分、囊肿感染史、囊肿远端结石/蛋白栓、手术时间及术后住院时间等方面比较,差异有统计学意义(P<0.05)。logistic回归分析显示,STAMP评分、囊肿感染史和手术时间是导致出现术后并发症的独立危险因素。结论儿童腹腔镜胆总管囊肿根治术后常见的并发症以Clavied-DindoⅡ、Ⅲ级为主,最常见的并发症为肠梗阻;STAMP评分、囊肿感染史、手术时间是导致出现术后并发症的独立危险因素。
Objective To explore the postoperative comlications of pediatric choledochal cyst and their risk factors after laparoscopic radical surgery.Methods From Aug.2015 to Jun.2023 a total of 498 children with choledochal cyst were hospitalized.According to the inclusion criteria,the clinical data of 464 children were retrospectively analyzed.39 children with postoperative complications were divided into complication group,and 425 children without complications were divided into non-complication group.Univariate analysis was used to analyze the influencing factors of postoperative complications,and multivariate logistic regression was used to analyze the independent risk factors affecting postoperative complications.Results All children underwent operation successfully.39 out of 464 cases experienced postoperative complications,with an incidence rate of 8.4%.Among them,there were 7 cases,12 cases,and 20 cases of Clavied-Dundo grade I,II,and II respectively,with no occurrence of grade IV or V complications.Among the complications,the incidence of intestinal obstruction,bile leakage and acute pancreatitis was relatively high.In the complication group,19 cases(48.7%)underwent conservative treatment and 20 cases(51.3%)underwent reoperation,all of which were discharged after recovery.There were significant differences between complication group and non-complication group in terms of preoperative age,STAMP score,history of choledochal cyst infection,biliary calculi or protein plug of distal cyst,operation time and and postoperative hospital stay(P<0.05).Logistic regression analysis showed that STAMP score,history of choledochal cyst infection,and operation time were independent risk factors for postoperative complications(P<0.05).ConclusionssT he postoperative complications of laparoscopic radical surgery for pediatric choledochal cyst were mainly Clavied Dundo grade II and II,with intestinal obstruction as the most common complication;STAMP score,history of choledochal cyst infection,and operation time were independent risk
作者
钟知足
陶波圆
曾纪晓
吴强
王哲
余家康
刘斐
徐晓钢
兰梦龙
梁子建
李燕秋
刘凤君
Zhong Zhizu;Tao Boyuan;Zeng Jixiao;Wu Qiang;Wang Zhe;Yu Jiakang;Liu Fei;Xu Xiaogang;Lan Menglong;Liang Zijian;Li Yanqiu;Liu Fengjun(Department of Gastrointestinal Surgery,Guangzhou Women&Children's Medical Center,Guangzhou Medical University,National Children Regional Medical Center Guangzhou 510120,China)
出处
《中华腔镜外科杂志（电子版）》
2024年第2期83-89,共7页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
国家自然科学基金(82170528)
广东省自然科学基金(2022A1515012254)
广州市科技计划市校(院)联合资助项目(202201020612)
广州市临床特色技术项目(2023C-TS48)
卫生健康技术重点推广项目(XM202403895)。
关键词
腹腔镜
月胆总管囊肿
术后并发症
危险因素
儿童
Laparoscopes
Choledochal cyst
Postoperative comlication
Risk factor
Child
