[1]杨斌斌,蔡多特,朱月玲,等.达芬奇机器人在儿童胆总管囊肿穿孔一期根治术中的应用价值[J].临床小儿外科杂志,2026,(03):238-242.[doi:10.3760/cma.j.cn101785-20251103-00038]
　Yang Binbin,Cai Duote,Zhu Yueling,et al.Application value of Da Vinci robot in one-stage radical resection for perforated choledochal cyst in children[J].Journal of Clinical Pediatric Surgery,2026,(03):238-242.[doi:10.3760/cma.j.cn101785-20251103-00038]
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达芬奇机器人在儿童胆总管囊肿穿孔一期根治术中的应用价值

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 期数: 2026年03 页码: 238-242 栏目: 专题·胆总管囊肿 出版日期: 2026-03-28
Title:
Application value of Da Vinci robot in one-stage radical resection for perforated choledochal cyst in children
作者:
杨斌斌1;  蔡多特1;  朱月玲2;  陈中雨3;  陈小丽1;  何雨晨1;  成泽海1;  陈青江1;  高志刚1
1. 浙江大学医学院附属儿童医院小儿普外科 儿童少年健康与疾病国家临床医学研究中心, 杭州 310052;
2. 浙江大学医学院附属儿童医院中医科 儿童少年健康与疾病国家临床医学研究中心, 杭州 310052;
3. 浙江大学医学院附属儿童医院放射科 儿童少年健康与疾病国家临床医学研究中心, 杭州 310052
Author(s):
Yang Binbin1;  Cai Duote1;  Zhu Yueling2;  Chen Zhongyu3;  Chen Xiaoli1;  He Yuchen1;  Cheng Zehai1;  Chen Qingjiang1;  Gao Zhigang1
1. Department of General Surgery, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents’ Health and Diseases, Hangzhou 310052, China;
2. Department of Traditional Chinese Medicine, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents’ Health and Diseases, Hangzhou 310052, China;
3. Department of Radiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents’ Health and Diseases, Hangzhou 310052, China
关键词:
达芬奇机器人手术; 胆总管囊肿穿孔; 一期根治术; 儿童; 腹腔镜手术
Keywords:
Da Vinci Robotic Surgery; Choledochal Cyst Perforation; Primary Radical Resection; Child; Laparoscopy
DOI:
10.3760/cma.j.cn101785-20251103-00038
摘要:
目的 探讨达芬奇机器人手术在儿童胆总管囊肿穿孔一期根治术中的应用价值。方法 回顾性分析 2018 年 1 月至 2025 年 6 月浙江大学医学院附属儿童医院小儿普外科收治的 23 例胆总管囊肿穿孔患儿临床资料,按手术方式分为达芬奇机器人手术组(12 例)和腹腔镜手术组(11 例),比较两组一期微创手术成功率、围手术期指标、住院及随访期间并发症发生率、住院费用等数据。结果 达芬奇组一期微创手术成功率为 100%(12/12),显著高于腹腔镜组的 63.6%(7/11),差异有统计学意义(P=0.037);腹腔镜组 4 例手术失败,其中 2 例因炎症水肿粘连严重中转开腹完成一期根治,2 例转为一期引流后分期根治。两组患儿术前基线资料、手术时间、术中出血量、术后禁食时间、术后住院时间、住院及随访期间并发症发生率差异均无统计学意义(P>0.05)。结论 儿童胆总管囊肿穿孔一期根治术中选择达芬奇机器人安全可行,能显著提高微创手术成功率,且不增加手术风险。
Abstract:
Objective To explore the application value of Da Vinci robotic surgery in one-stage radical resection for choledochal cyst perforation in children.Methods A retrospective analysis was conducted for the relevant clinical data of 23 children with choledochal cyst perforation at our hospital from January 2018 to June 2025.Based upon specific surgical approaches,they were assigned into two groups of Da Vinci robotic surgery and laparoscopy.Success rate of one-stage mini-invasive surgery,perioperative indicators,incidence of complications during hospitalization and follow-ups and hospitalization expenses were compared.Results The success rate of one-stage mini-invasive surgery was 100%(12/12) in Da Vinci group.It was significantly higher than 63.6%(7/11) in laparoscopic group with a statistically significant difference (P=0.037).Among 4 failed cases in laparoscopic group,2 were converted into open surgery due to severe inflammatory edema and adhesions for completing one-stage radical resection.Another two failed to complete one-stage radical resection and were converted into one-stage drainage after staged radical surgery.No significant inter-group differences existed in preoperative baseline profiles,operative duration,intraoperative volume of blood loss,postoperative fasting time,postoperative hospital stay or the incidence of complications during hospitalization and follow-ups. Conclusions For pediatric choledochal cyst perforation,using Da Vinci robot in one-stage radical surgery is both safe and feasible.It can significantly enhance the success rate of mini-invasive surgery without elevated surgical risks.

参考文献/References:

[1] Ohba G, Yamamoto H, Nakayama M, et al.Single-stage operation for perforated choledochal cyst[J].J Pediatr Surg, 2018, 53(4):653-655.DOI:10.1016/j.jpedsurg.2017.07.014.
[2] Zhang GW, Wang HM, Hu JY, et al.A nomogram for predicting choledochal cyst with perforation[J].Pediatr Surg Int, 2024, 40(1):129.DOI:10.1007/s00383-024-05710-3.
[3] Ojha S, Agarwala P, Sharma R, et al.Ruptured choledochal cyst: one-stage or two-stage, open or laparoscopic surgery?[J].J Minim Access Surg, 2023, 19(1): 138-140.DOI:10.4103/jmas.jmas_206_21.
[4] Jin Y, Zhang YB, Cai DT, et al.Robot-assisted resection of intestinal duplication in children[J].J Laparoendosc Adv Surg Tech A, 2022, 32(12):1288-1292.DOI: 10.1089/lap.2022.0173.
[5] Chen S, Gao ZG, Chen QJ, et al.Robot-assisted resection of choledochal cyst in neonates[J].BMC Pediatr, 2024, 24(1):473.DOI:10.1186/s12887-024-04942-5.
[6] Kim YJ, Kim SH, Yoo SY, et al.Comparison of clinical and radiologic findings between perforated and non-perforated choledochal cysts in children[J].Korean J Radiol, 2022, 23(2):271-279.DOI:10.3348/kjr.2021.0169.
[7] Murakami M, Tsuruno Y, Maeda S, et al.Laparoscopic versus open choledochal cyst excision focusing on postoperative complications: a retrospective outcomes study from Kyushu Pediatric Surgery Study Group in Japan[J].J Pediatr Surg, 2025, 60(12):162558.DOI:10.1016/j.jpedsurg.2025.162558.
[8] Xie XL, Feng LW, Li KW, et al.Learning curve of robot-assisted choledochal cyst excision in pediatrics: report of 60 cases[J].Surg Endosc, 2021, 35(6): 2690-2697.DOI:10.1007/s00464-020-07695-1.
[9] Phugat S, Choudhury P, Jain V, et al.Type VI choledochal cyst and the anomalous pancreaticobiliary junction: a systematic review[J].J Indian Assoc Pediatr Surg, 2025, 30(3):277-289.DOI:10.4103/jiaps.jiaps_204_24.
[10] Kumar A, Sonali S, Kumar S, et al.Acute abdomen with jaundice: a clue to extrahepatic biliary tract perforation[J].Int J Surg Case Rep, 2022, 94:107127.DOI:10.1016/j.ijscr.2022.107127.

备注/Memo

收稿日期:2025-11-3。
基金项目:浙江省"尖兵""领雁"研发攻关计划资助(2023C03029)
通讯作者:高志刚,Email:ebwk@zju.edu.cn

更新日期/Last Update: 1900-01-01