【摘要】 目的探讨腹腔镜对婴儿阻塞性黄疸的鉴别诊断及治疗作用。方法对23例经内科保守治疗7￣14d,黄疸无明显消退,复查肝功能及胆红素无明显改善的黄疸患儿,采取全麻下腹腔镜胆道探查术。结果10例确诊为婴儿肝炎综合症,于术中用生理盐水冲洗胆道,痊愈出院。13例诊断为胆道闭锁,其中7例放弃治疗;6例行肝门空肠R-Y吻合,胆道重建术后,4例痊愈出院,2例走访,2例出现胆管炎反复发作。结论对婴儿阻塞性黄疸内科保守治疗无效者,行腹腔镜检查可明确病因,同时可在腹腔镜直视下行肝外胆道冲洗、肝组织活检等,能有效协助诊断与治疗,具有创伤小,恢复快的特点。更多还原

【Abstract】 Objective To elucidate the differential diagnosis and efficacy by laparoscopy in infantile obstrutive jaundice. Methods Biliary tracts of 23 cases of obstructive jaundice ,who were no jaundice obviously extinction,hepatic function and bilirubin index also no significant improved in the re-examination after 7~14 days medical conservative treatment, were explored by laparoscope under general anesthesia . Results 10 cases of infantile hepatitis syndrome were definitely diagnosed used physioligical salt solution cleansing the biliary tract ,all recovery discharge, biliaryatresia in 13 cases,7 cases of them abandon therapy,other 6 cases performed porta-hepatis-jejunun R-Y anastomosis, 4 cases of them discharge, after biliary tract reconstruction hepatitis in the fellowed up period. Conclusion For the patients with obstructive jaundice who are no efficacy using medical conservative therapy,should adopt the laparoscopy,because the laparocopy coule define the cause of the disease,at the same time can direct clean the extrahepatic biliary tract under the laparoscope,doing hepatic tissue biopy examination etc,effective help the diagnosis and could treatment of the infantile obstructive jaundice,it also have features of small trauma,rapid recovery.更多还原