白剑+梁劲文+高卫华

[摘要] 目的 观察腹腔镜微创手术治疗小儿先天性胆总管囊肿的疗效。 方法 选取南海妇幼保健院和广州市妇女兒童医疗中心2015年1月～2017年1月共50例先天性胆总管囊肿患儿作为研究对象，以随机分配为原则，分为观察组和对照组各25例。对照组采用传统手术进行治疗，观察组采用腹腔镜微创手术进行治疗，对比两组患儿的临床疗效。 结果 观察组患儿平均出血量、排气时间、住院时间、并发症发生率、复发率均低于对照组患儿，差异有统计学意义（P<0.05）。 结论 腹腔镜微创手术治疗小儿先天性胆总管囊肿具有良好的临床疗效，并发症发生率低、复发率低，预后良好，值得在临床推广应用。

[关键词] 腹腔镜微创手术；先天性胆总管囊肿；小儿

[中图分类号] R726.5 [文献标识码] A [文章编号] 2095-0616（2017）08-79-03

[Abstract] Objective To observe curative effect of laparoscopic minimally invasive procedure in treatment of children with congenital choledochal cyst. Methods 50 children with congenital choledochal cyst who were admitted to Nanhai Maternity and Child Healthcare Hospital of Foshan Guangdong and Guangzhou Women and Childrens Medical Center form January 2015 to January 2017 were selected as research objects. They were divided into the observation group and the control group according to random allocation， with 25 in each. The control group was given traditional operation for treatment while the observation group was treated by laparoscopic minimally invasive procedure. Clinical curative effects of children in two groups were compared. Results Mean blood loss， exhaust time， hospitalization stay， complication rate and recurrent rate of children in the observation group were all lower than those of the control group. Differences were statistically significant （P<0.05）. Conclusion Laparoscopic minimally invasive procedure in treatment of children with congenital choledochal cyst has a good clinical curative effect， low complication rate， recurrent rate and good prognosis， which is worthy of clinical promotion and application.

[Key words] Laparoscopic minimally invasive procedure； Congenital choledochal cyst； Children

先天性胆总管囊肿又被称为胆总管扩张症，目前医学界对其病因尚不明确，大多为先天性发育畸形，可能与先天性因素胆管壁薄弱、胆总管远端梗阻有关，导致管内的压力上升，从而引起扩张[1]。高发期大多为儿童和成年期，临床症状主要表现为间歇性上腹痛、右上腹肿块和黄疸，同时存在恶心、呕吐、厌食等表现。对于临床症状不明显的患者，则需要通过腹部B超（B-scan ultrasonography）、CT（computed tomography，电子计算机断层扫描）、胆道造影等进行判断，一旦发现，要立刻进行手术治疗[2]。传统临床中大多采用开腹手术的方式，但是患儿的身体发育还不成熟，如果采用开腹手术，会严重影响到患儿的健康发育[3]。因此，本研究采用腹腔镜胆总管囊肿切除、肝管空肠Roux-en-Y吻合术进行治疗，取得了良好的效果。具体报道如下。

1 资料与方法

1.1 一般资料

选取广东省佛山市南海妇幼保健院和广州市妇女儿童医疗中心2015年1月～2017年1月收治的50例先天性胆总管囊肿患儿作为研究对象，纳入排除标准：符合先天性胆总管囊肿诊断标准；……