Yao Zhiguang,Wen Zhe,Ma Da,et al.Causes and treatments of mid-to-long-term complications after laparoscopic choledochal cyst in children[J].Journal of Clinical Pediatric Surgery,2019,18(07):568-572.[doi:10.3969/j.issn.1671-6353.2019.07.010]
小儿腹腔镜胆总管囊肿术后中远期并发症原因分析及处理
- Title:
- Causes and treatments of mid-to-long-term complications after laparoscopic choledochal cyst in children
- Keywords:
- Laparoscopes; Choledochal Cyst/CO
- 分类号:
- R726;R616.5;R575.7
- 摘要:
- 目的 初步探讨小儿腹腔镜胆总管囊肿术后中远期并发症的发生原因及处理策略。方法 收集2010年12月至2017年8月间广州市妇女儿童医疗中心收治的腹腔镜胆总管囊肿根治术后出现中远期并发症患儿的临床资料，并进行总结分析。结果 纳入6例腹腔镜胆总管囊肿术后出现中远期并发症的患儿（大部分为外院手术后转入），6例初次手术根治的方式均为腹腔镜手术。出现术后并发症的时间为2~12个月（中位时间8.70个月），并发症分别为：胆袢梗阻1例，胆肠吻合口狭窄3例，腹内疝1例，严重反流性胆管炎1例。患儿均接受手术治疗，其中5例于腹腔镜下完成手术，1例行开放手术。患儿均获得随访，随访时间6个月至3年，均恢复良好，无一例复发。结论 腹腔镜胆总管囊肿根治术后中远期并发症多与缝合、建立隧道等手术操作有关，因此手术技术的提高和操作细节的把握是减少中远期并发症出现的关键。部分患儿术后并发症的处理可以在腹腔镜下完成。
- Abstract:
- Objective To analyze the causes of mid-to-long-term postoperative complications after laparoscopic choledochal cyst surgery in children and discuss the methods of their surgical interventions.Methods Retrospective analysis were performed for the clinical data of children with med-to-long-term complications after laparoscopic choledochal cyst surgery from December 2010 to August 2017 at Guangzhou Women & Children’s Medical Center.Results Six children with mid-to-long-term complications after laparoscopic choledochal cyst surgery were admitted into our hospital and most of them were transferred from other hospitals after surgery.The mean interval between onset of complication and surgery was 8.70(2-12) months.The complications were Roux-en-Y loop obstruction(n=1),bilio-jejunal anastomotic stenosis(n=3),abdominal internal hernia(n=1) and severe refluxing cholangitis(n=1).Surgical procedures were laparoscopy(n=5) and laparotomy(n=1).During a follow-up period of 6 to 36 months,all of them recovered well.Conclusion Most mid-to-long-term postoperative complications after choledochal cyst excision are correlated with such surgical manipulation as suturing and tunnel placement.Some postoperative complications may be treated by laparoscopy.
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备注/Memo
收稿日期:2018-12-2。
基金项目:东莞市社会科技发展一般项目（编号：201750715028118）
通讯作者:温哲,Email:wenzhe2005@163.com