Yao Zhiguang,Wen Zhe,Ma Da,et al.Causes and treatments of mid-to-long-term complications after laparoscopic choledochal cyst in children[J].Journal of Clinical Pediatric Surgery,,18():568-572.[doi:10.3969/j.issn.1671-6353.2019.07.010]
Causes and treatments of mid-to-long-term complications after laparoscopic choledochal cyst in children
- Keywords:
- Laparoscopes; Choledochal Cyst/CO
- CLC:
- R726;R616.5;R575.7
- Abstract:
- Objective To analyze the causes of mid-to-long-term postoperative complications after laparoscopic choledochal cyst surgery in children and discuss the methods of their surgical interventions.Methods Retrospective analysis were performed for the clinical data of children with med-to-long-term complications after laparoscopic choledochal cyst surgery from December 2010 to August 2017 at Guangzhou Women & Children’s Medical Center.Results Six children with mid-to-long-term complications after laparoscopic choledochal cyst surgery were admitted into our hospital and most of them were transferred from other hospitals after surgery.The mean interval between onset of complication and surgery was 8.70(2-12) months.The complications were Roux-en-Y loop obstruction(n=1),bilio-jejunal anastomotic stenosis(n=3),abdominal internal hernia(n=1) and severe refluxing cholangitis(n=1).Surgical procedures were laparoscopy(n=5) and laparotomy(n=1).During a follow-up period of 6 to 36 months,all of them recovered well.Conclusion Most mid-to-long-term postoperative complications after choledochal cyst excision are correlated with such surgical manipulation as suturing and tunnel placement.Some postoperative complications may be treated by laparoscopy.
References:
1 Wen Z,Liang H,Liang J,et al.Evaluation of the learning curve of laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children:CUSUM analysis of a single surgeon’s experience[J].Surgical Endoscopy,2017,31(2):778-787.
2 侯文英,李龙,明安晓,等.经脐单一切口腹腔镜先天性胆总管囊肿切除肝管空肠Roux-en-Y吻合手术技巧[J].中华小儿外科杂志,2013,34(7):497-500.DOI 10.3760/cma.j.issn.0253-3006.2013.07.005.Hou WY,Li L,Ming AX,et al.Surgical skills of laparoscopic single-incision peri-umbilical excision of congenital common bile duct cysts plus Roux-en-Y hepaticojejunostomic anastomosis[J].Chinese Journal of Pediatric Surgery,2013,34(7):497-500.DOI 10.3760/cma.j.issn.0253-3006.2013.07.005.
3 温哲,刘斐,王哲,等.腹腔镜胆总管囊肿根治术的手术体会及技术改进[J].国际外科学杂志,2013,40(6):379-382.DOI:10.3760/cma.j.issn.1673-4203.2013.06.007.Wen Z,Liu F,Wang Z,et al.Surgical experiences and technique improvements of laparoscopic radical excision of common bile duct cysts[J].International Surgery of Surgery,2013,40(6):379-382.DOI:10.3760/cma.j.issn.1673-4203.2013.06.007.
4 侯文英,刘垚,张艳霞,等.双半圆单层连续缝合法在腹腔镜胆肠吻合术的应用[J].中国微创外科杂志,2014,14(11):1036-1038.DOI:10.3969/j.issn.1009-6604.2014.11.019.Hou WY,Liu Y,Zhang YX,et al.Application of double semi-circular single-layer continuous suturing during laparoscopic Roux-en-Y[J].Chinese Journal of Minimally Invasive Surgery,2014,14(11):1036-1038.DOI:10.3969/j.issn.1009-6604.2014.11.019.
5 Diao M,Li L,Cheng W.Role of laparoscopy in treatment of choledochal cysts in children[J].Pediatr Surg Int,2013,29(8):777-786.DOI:10.1007/s00383-013-3266-z.
6 刁美,李龙,叶茂,等.胆总管囊肿根治术后胆道梗阻的原因分析和治疗策略[J].中华小儿外科杂志,2017,38(4):274-277.DOI:10.3760/cma.j.issn.0253-3006.2017.04.007.Diao M,Li L,Ye M,et al.Cause analysis and treatment strategies of bile duct obstructions after radical surgery for choledochal cysts[J].Chinese Journal of Pediatric Surgery,2017,38(4):274-277.DOI:10.3760/cma.j.issn.0253-3006.2017.04.007.
7 高海军,陈光,王浩,等.经切割球囊联合普通球囊扩张治疗肝移植术后胆管吻合口狭窄[J].实用器官移植电子杂志,2016,4(4):217-221.DOI:10.3969/j.issn.2095-5332.2016.04.005.Gao HJ,Chen G,Wang H,et al.Cutting balloon plus routine balloon dilatations in the treatment of anastomotic biliary strictures after hepatic transplantations[J].Practical Journal of Organ Transplantation(Electronic Version),2016,4(4):217-221.DOI:10.3969/j.issn.2095-5332.2016.04.005.
8 Saad WEA,Saad NEA,Davies MG,et al.Transhepatic balloon dilation of anastomotic biliary strictures in liver transplant recipients:the significance of a patent hepatic artery[J].Journal of Vascular & Interventional Radiology,2005,16(9):1221-1228.DOI:10.1097/01.RVI.0000173281.69988.57.
9 Podnos YD,Jimenez JC,Wilson SE,et al.Complications after laparoscopic gastric bypass:a review of 3464 cases[J].Archives of Surgery,2003,138(9):957.DOI:10.1001/archsurg.138.9.957.
10 Aghajani E,Jacobsen H J,Nergaard B J,et al.Internal hernia after gastric bypass:a new and simplified technique for laparoscopic primary closure of the mesenteric defects[J].Journal of Gastrointestinal Surgery,2012,16(3):641-645.DOI:10.1007/s11605-011-1790-5.
11 Hirahara N,Matsubara T,Hayashi H,et al.Easy and secure closure of Petersen’s defect after laparoscopic distal gastrectomy with Roux-en-Y reconstruction[J].Journal of Laparoendoscopic & Advanced Surgical Techniques Part A,2015,25(1):55-59.DOI:10.1089/lap.2014.0402.
12 张皓,李涛,吐尔洪江·吐逊,等.腹腔镜胆管空肠Roux-en-Y吻合术治疗胆道疾病的探讨[J].中华腔镜外科杂志(电子版),2017,10(3):150-154.DOI:10.3877/cma.j.issn.16746899.2017.03.007.Zhang H,Li T,et al.Laparoscopic Roux-en-Y hepaticojejunostomic anastomosis in the treatment of bile duct diseases[J].Chinese Journal of Laparoscopic Surgery(Electronic Version),2017,10(3):150-154.DOI:10.3877/cma.j.issn.16746899.2017.03.007.
13 Diao M,Li L,Zhang J Z,et al.A shorter loop in Roux-Y hepatojejunostomy reconstruction for choledochal cysts is equally effective:preliminary results of a prospective randomized study[J].Journal of Pediatric Surgery,2010,45(4):845-847.DOI:10.1016/j.jpedsurg.2009.12.022.
Memo
收稿日期:2018-12-2。
基金项目:东莞市社会科技发展一般项目（编号：201750715028118）
通讯作者:温哲,Email:wenzhe2005@163.com