Zhu Xiaomin,Shi Yingzuo,Fang Zhihong,et al.Treatment of choledochal cyst by laparoscopy plus fibrocholedochoscopy versus traditional laparoscopy[J].Journal of Clinical Pediatric Surgery,,():659-664.[doi:10.3760/cma.j.cn101785-202212045-010]
Treatment of choledochal cyst by laparoscopy plus fibrocholedochoscopy versus traditional laparoscopy
- Keywords:
- Congenital Choledochal Cyst; Laparoscopy; Choledochoscopy; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the efficacy of laparoscopy plus fibrocholedochoscopy versus traditional laparoscopy for choledochocyst in children.Methods A retrospective study was performed for 40 children with choledochal cyst.According to different surgical protocols,they were assigned into two groups of observation (n=20) and control (n=20).Control group underwent laparoscopic resection of choledochal cyst while observation group had laparoscopy plus fiberoptic choledochoscopy radical resection of choledochal cyst.Operative duration,protein plug detection rate,one-time clearance rate,need for a conversion into open surgery,complications,changes in internal environment parameters preoperatively,1/3 day postoperatively,as well as postoperative recovery status (time to full enteral nutrition,time to anal exhaust & length of hospitalization stay).Results Operative duration was (227.80±39.74) min in observation group and (189.50±5.92) min in control group.There was statistically significant inter-group difference (P＜0.05).Detection rate of protein plugs was 65.00%(13/20) in observation group and 60.00%(12/20) in control group.There was no statistically significant inter-group difference (P>0.05).One-time clearance rate was 100.00%(13/13) in observation group and 83.33%(10/12) in control group.There was no statistically significant inter-group difference (P>0.05).Comparing Day 1 post-operation with pre-operation,FT3 level declined while the levels of Cor and ACTH spiked (P<0.05).Comparing Day 1/3 post-operation,FT3level rose while the levels of Cor μg/L and ACTH [(18.42±4.02) vs.(33.67±6.72),(19.88±4.53) vs.(38.19±7.04) ng/L]dropped (P<0.05).Comparing Day 3 post-operation with pre-operation,FT3 level declined while the levels of Cor and ACTHjumped (P<0.05).Comparing Day 3 post-operation with control group,there was no statistically significant inter-group difference (P>0.05).Comparing observation and control groups,full enteral nutrition time ,anal exhaust timeand hospitalization stayhad statistically significant differences (P<0.05).Conclusions As compared with traditional laparoscopy,laparoscopy plus choledochal cyst radical operation are more efficacious for choledochal cyst in children.While ensuring the detection rate of protein thrombin and one-time clearance rate,it has less impact on internal environment of children with an excellent safety.
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Memo
收稿日期:2022-12-27。
基金项目:无锡市科技资金发展项目(Y20212033)
通讯作者:石英佐,Email:954100253@qq.com