Wang Bo,Xi Hongwei,Zhao Zheng,et al.Comparative study of single-site laparoscopic and traditional four-hole laparoscopic treatment of pediatric choledochal cyst[J].Journal of Clinical Pediatric Surgery,,20():658-663.[doi:10.12260/lcxewkzz.2021.07.012]
Comparative study of single-site laparoscopic and traditional four-hole laparoscopic treatment of pediatric choledochal cyst
- Keywords:
- Laparoscope; Single Site; Choledochal Cyst/SU; Comparative Study
- CLC:
- R726;R616.5;R575.7
- Abstract:
- Objective To compare clinical application value of single-site laparoscopic hepaticojejunostomy (SSLH) versus traditional four-hole laparoscopic hepaticojejunostomy (TFLH) for children with choledochal cysts (CDCs).Methods Thirty children undergoing SSLH between January 2016 to June 2019 were recruited.Another 30 children undergoing TFLH were matched for age,gender,CDC type,size and operative surgeon.The surgical outcomes of CDC children were retrospectively compared.Results SSLH was successfully completed for 28 children while another 2 cases had an addition of one extra operative hole in left upper abdomen.Meanwhile,TFLH was all successful.The average operative duration was (238.00±50.00) min in SSLH group versus (201.63±65.48) min in TFLH group.And the difference was statistically significant (t=-2.418,P<0.05).Other outcomes of average volume of intraoperative blood loss,postoperative recovery of drinking time,postoperative removal of abdominal drainage tube,postoperative hospital stay,hospitalization expenses and complication rate were similar for two groups.The differences were not statistically significant (P>0.05).Conclusion If performed by experienced laparoscopic hepaticobiliary surgeons,SSLH is safe,effective and mini-invasive.As compared with TFLH,no significant difference exists in recent complications.Long-term complications require further follow-up studies.
References:
1 Qiao GL,Li L,Li SL,et al.Laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts in China:a multicenter study[J].Surg Endosc,2015,29(1):140-144.DOI:10.1007/s00464-014-3667-7.
2 Blanco FC,Kane TD.Single-port laparoscopic surgery in children:concept and controversies of the new technique[J].Minimally Invasive Surgery,2012,2012:232347.DOI:10.1155/2012/232347.
3 Seims AD,Nice TR,Mortellaro VE,et al.Routine utilization of single-incision pediatric endosurgery (SIPES):a 5-year institutional experience[J].J Laparoendosc Adv Surg Tech A,2015,25(3):252-255.DOI:10.1089/lap.2014.0492.
4 Xi HW,Duan WQ,Cui QQ,et al.Transumbilical Single-Site Laparoscopic Inguinal Hernia Inversion and Ligation in Girls[J].J Laparoendosc Adv Surg Tech A,2015,25(6):522-525.DOI:10.1089/lap.2014.0383.
5 Diao M,Li L,Dong N,et al.Single-incision laparoscopic Roux-en-Y hepaticojejunostomy using conventional instruments for children with choledochal cysts[J].Surg Endosc,2012,26(6):1784-1790.DOI:10.1007/s00464-011-2110-6.
6 Farello GA,Cerofolini A,Rebonato M,et al.Congenital choledochal cyst:video-guided laparoscopic treatment[J].Surg Laparosc Endosc,1995,5(5):354-358.DOI:10.1007/BF00189002.
7 李龙,余奇志,刘刚,等.经腹腔镜行先天性胆总管囊肿根治切除术的技术要点[J].中华普通外科杂志,2002,17(8):473-475.DOI:10.3760/j.issn:1007-631X.2002.08.010. Li L,Yu QZ,Liu G,et al.Technical essentials of laparoscopic total cyst excision with Roux-y hepatoenterostomy for choledochal cyst[J].Chin J Gen Sury,2002,17(8):473-475.DOI:10.3760/j.issn:1007-631X.2002.08.010.
8 李索林,时保军,温哲,等.腹腔镜下胆总管囊肿切除、胆道重建术[J].中华小儿外科杂志,2004,25(4):298-301.DOI:10.3760/cma.j.issn.0253-3006.2004.04.002. Li SL,Shi BJ,Wen Z,et al.Laparoscope-assisted resection of choledochal cyst and biliary reconstruction[J].Chin J Pediatr Sury,2004,25(4):298-301.DOI:10.3760/cma.j.issn.0253-3006.2004.04.002.
9 王斌,冯奇,毛建雄,等.腹腔镜治疗先天性胆总管囊肿的临床研究[J].中华小儿外科杂志,2012,33(10):733-736.DOI:10.3760/cma.j.issn.0253-3006.2012.10.004. Wang B,Feng Q,Mao JX,et al.Laparoscopic resection of congenital choledochal cyst in children[J].Chin J Pediatr Sury,2012,33(10):733-736.DOI:10.3760/cma.j.issn.0253-3006.2012.10.004.
10 Diao M,Li L,Li Q,et al.Single-incision versus conventional laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts:a case-control study[J].World J Surg,2013,37(7):1707-1713.DOI:10.1007/s00268-013-2012-y.
11 唐应明,何国庆,罗淼,等.经脐单切口腹腔镜治疗小儿先天性胆总管囊肿的体会[J].中华小儿外科杂志,2015,36(4):301-303.DOI:10.3760/cma.j.issn.0253-3006.2015.04.015. Tang YM,He GQ,Luo M,et al.Experience with laparoscopic single-incision laparoscopic treatment of congenital choledochal cyst in children[J].Chin J Pediatr Sury,2015,36(4):301-303.DOI:10.3760/cma.j.issn.0253-3006.2015.04.015.
12 何少华,汤坤彬,徐迪.经脐单部位三通道腹腔镜胆总管囊肿根治术的临床体会(附48例报告)[J].腹腔镜外科杂志,2018,23(4):302-306.DOI:10.13499/j.cnki.fqjwkzz.2018.04.302. He SH,Tang KB,Xu D.Transumbilical single-site laparoscopic choledochal cyst excision with three channels:a report of 48 cases[J].Journal of Laparoscopic Surgery,2018,23(4):302-306.DOI:10.13499/j.cnki.fqjwkzz.2018.04.302.
13 Fukumoto K,Miyajima A,Hattori S,et al.The learning curve of laparoendoscopic single-site adrenalectomy:an analysis of over 100 cases[J].Surg Endosc,2017,31(1):170-177.DOI:10.1007/s00464-016-4950-6.
14 卜浩,成伟,尹新民,等.儿童胆总管囊肿腹腔镜治疗的技术细节分析(附36例报告)[J].中华腔镜外科杂志(电子版),2018,11(6):37-40.DOI:10.3969/j.issn.1009-6604.2014.11.019. Bu H,Cheng W,Yin XM,et al.Technical details in laparoscopic treatment of choledochal cyst in children:a report of 36 cases[J].Chin J Laparoscopic Sur (Electronic Edition),2018,11(6):37-40.DOI:10.3969/j.issn.1009-6604.2014.11.019.
15 刁美,李龙.经脐单切口腹腔镜技术治疗胆总管囊肿的手术要点及技巧[J].临床小儿外科杂志,2019,18(7):536-541.DOI:10.3969/j.issn.1671-6353.2019.07.003. Diao M,Li L.Surgical essentials and techniques of transumbilical single incision laparoscopy for choledochal cysts[J].J Clin Ped Sur,2019,18(7):536-541.DOI:10.3969/j.issn.1671-6353.2019.07.003.
16 Narayanan SK,Chen Y,Narasimhan KL,et al.Hepaticoduodenostomy versus hepaticojejunostomy after resection of choledochal cyst:A systematic review and meta-analysis[J].J Pediatr Surg,2013,48(11):2336-2342.DOI:10.1016/j.jpedsurg.2013.07.020.
17 汤绍涛,常晓盼.腹腔镜下胆总管囊肿切除术后吻合口狭窄问题[J].临床小儿外科杂志,2019,18(7):542-544.DOI:10.3969/j.issn.1671-6353.2019.07.004. Tang ST,Chang XP.Anastomotic stenosis after laparoscopic choledochal cyst surgery[J].J Clin Ped Sur,2019,18(7):542-544.DOI:10.3969/j.issn.1671-6353.2019.07.004.
Memo
收稿日期:2019-11-18。
基金项目:山西省卫生计生委一般项目（编号：2015058）
通讯作者:席红卫,Email:xihongwei148@sina.com