【摘要】 目的比较腹腔镜手术与开腹手术治疗成人I型先天性胆总管囊肿的疗效。方法回顾性分析2012年1月至2019年1月金华市中心医院收治的41例成人I型先天性胆总管囊肿患者,均行胆总管囊肿切除+肝总管空肠Roux-en-Y吻合术。按照手术方式分为腹腔镜组(n=21例)和开腹组(n=20例),比较两组患者手术时间、术中出血量、术后肛门排气时间、术后饮食恢复时间、术后住院时间及术后并发症发生情况。结果两组患者均顺利手术,无死亡病例发生。腹腔镜组手术时间明显长于开腹组[(245.51±53.23)min vs (165.38±35.52)min,P<0.001],但腹腔镜组在术中出血量[(120.21±45.42)mL vs (165.75±56.13)mL]、术后肛门排气时间[(2.62±0.81)d vs (3.38±0.67)d]、术后饮食恢复时间[(6.53±1.71)d vs (8.24±1.95)d]、术后住院时间[(10.24±3.82)d vs (13.95±3.62)d]方面明显少于开腹组,差异具有统计学意义(P<0.05)。两组患者术后并发症发生率无统计学差异(4/21 vs 5/20,P=0.65)。结论腹腔镜下施行胆总管囊肿手术具有创伤小、恢复快等优势,同时不增加术后并发症的发生率,可有条件的医院积极开展。更多还原

【Abstract】 objective To compare laparoscopy and laparotomy for treatment of adult type I congenital choledochal cyst. Methods A total of 41 patients were included from Jan. 2012 to Jan. 2019 and the study was done in Jinhua Central Hospital. All patients received choledochal cyst resection plus Roux-en-Y anastomosis of choledochal jejunum. Among them, 21 for laparoscopy and 20 for laparotomy. The operation time, intraoperative blood loss, postoperative anal exhaust time, postoperative dietary recovery time, postoperative hospitalization time and complications were measured as the main outcomes. Results The operation time was significantly longer in the laparoscopy group than that in laparotomy group [(245.51±53.23)min vs(165.38±35.52)min, P<0.001]. However, less intraoperative blood loss [(120.21±45.42)m L vs(165.75±56.13)m L], less postoperative anal exhaust time [(2.62±0.81)d vs(3.38±0.67)d], less postoperative dietary recovery time [(6.53±1.71)d vs(8.24±1.95)d], and less postoperative hospitalization time [(10.24±3.82)d vs(13.95±3.62)d] were seen in laparoscopy group than those in laparotomy group(P<0.05). There was no significant difference in the incidence of postoperative complications between the groups(4/21 vs 5/20, P=0.65). Conclusion For adult type I congenital choledochal cyst, laparoscopic surgery has the advantages of minor trauma, rapid recovery, which does not increase the incidence of postoperative complications.更多还原