Tao Boyuan,Zhong Zhizu,Zeng Jixiao,et al.Clinical comparison of transumbilical single-port laparoscopic versus conventional four-port laparoscopic treatment of pediatric choledochal cyst[J].Journal of Clinical Pediatric Surgery,2025,(04):331-338.[doi:10.3760/cma.j.cn101785-202307044-006]
Clinical comparison of transumbilical single-port laparoscopic versus conventional four-port laparoscopic treatment of pediatric choledochal cyst
- Keywords:
- Choledochal Cyst; Surgical Procedures; Operative; Methods; Laparoscopy; Treatment Outcome; Comparative Study; Child
- Abstract:
- Objective To compare clinical application value of transumbilical single-port laparoscopic hepaticojejunostomy (TUSPLH) versus conventional four-port laparoscopic hepaticojejunostomy (CLH) for children with choledochal cyst using conventional laparoscopic instruments.Methods From June 2019 to December 2022,87 children with choledochal cyst were hospitalized.According to the inclusion criteria,the clinical data of 85 children were retrospectively reviewed.Forty-four children underwent TUSPLH while another 41 children CLH.Baseline profiles,operative findings and curative outcomes were compared between two groups.Results All operation were successfully completed.Age,volume of blood loss,drainage tubing rate,intestinal function recovery time,postoperative hospital stay and complication rate showed no significant inter-group difference.The inter-group differences in operative duration,pain score and incision healing satisfaction score differed significantly.One child in TUSPLH group experienced postoperative bile leakage and healed after 12-day abdominal drainage.Another child in CLH group had postoperative hemorrhage.Emergency laparoscopic exploration revealed hemorrhage of cyst separation surface.After surgical hemostasis,the child recovered smoothly.The remainders had no onset of such complications as anastomotic stenosis,cholangitis or pancreatitis.No mortality occurred in neither groups.Conclusions For pediatric choledochal cyst,both TUSPLH and CLH with conventional laparoscopic instruments may achieve similar short/middle-term outcomes.The former offers a satisfactory cosmetic incision and milder postoperative pain.However,there are greater surgical difficulty and longer operative duration.For recurrent preoperative biliary tract infections and imaging findings necessitating intraoperative cholangioplasty,TUSPLH should be performed with more caution.
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Memo
收稿日期:2023-7-22。
基金项目: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)
通讯作者:曾纪晓,Email:zengjixiao@163.com