Li Bingliang,Jin Yuanyuan,Wu Xiaoxia,et al.Laennec’s capsule-guided sharp-blunt dissection technique for hilar management during laparoscopic Kasai surgery for biliary atresia[J].Journal of Clinical Pediatric Surgery,,():1027-1031.[doi:10.3760/cma.j.cn101785-202507032-006]
Laennec’s capsule-guided sharp-blunt dissection technique for hilar management during laparoscopic Kasai surgery for biliary atresia
- Keywords:
- Biliary Atresia; Portoenterostomy; Hepatic; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the feasibility and effectiveness of sharp shear plus blunt dissection technique based upon anatomical gap for hepatic hilar fibrous masses in pediatric type Ⅲ.biliary atresia (BA) laparoscopic Kasai surgery. Methods The relevant clinical data were retrospectively reviewed for 10 children hospitalized with type Ⅲ BA from January 2024 to March 2025.According to surgical approaches,they were assigned into study and control groups (n=5 each).Acute shear plus blunt peeling were employed in study group while traditional sharp shearing was adopted in control group.The major observation parameters included operative age,operative duration,hilar fiber block removal time,direct intraoperative measurement of hilar resection surface area and postoperative recovery. Results Significant inter-group difference existed in intraoperative clearance time of hilar fiber mass[(6.4±1.1) vs.(12.2±1.9)min](P<0.001).No significant inter-group differences existed in operative duration,intraoperative volume of blood loss,postoperative hospitalization stay,complete clearance of jaundice at Month 3 post-operation,count of postoperative cholangitis cases and autologous liver survival status at the end of follow-up period (P>0.05).Autologous liver survival was achieved during a postoperative follow-up period of (3-18) month. Conclusions During laparoscopic Kasai operation,the technique of "sharp shear plus blunt dissection" of hilar fiber block based upon precise anatomical gap is both accurate and effective.It may shorten the time of key procedures to a certain extent and btain ideal bile drainage.
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Memo
收稿日期:2025-7-15。
基金项目:山西省卫健委课题(2022074);山西省儿童医院院级课题项目(2023002)
通讯作者:任红霞,Email:renhongxia100@sina.com