Laparoscopic surgery for treatment of hepaticojejunostomy strictures after cholangiectasis surgery in children
10.3760/cma.j.cn113884-20220914-00361
- VernacularTitle:腹腔镜手术治疗小儿胆管扩张症根治术后胆肠吻合口狭窄的临床研究
- Author:
Zhensheng LIU
1
;
Decheng WEI
;
Yong YANG
;
Jian BIAN
;
Shiqin QI
Author Information
1. 安徽省儿童医院普外科，合肥 230001
- Keywords:
Laparoscopy;
Cholangiectasis;
Hepaticojejunostomy stricture;
Pediatric
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(12):902-906
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the safety and feasibility of laparoscopic surgery for treatment of hepaticojejunostomy strictures after cholangiectasis surgery in children.Methods:The clinical data of 12 children was retrospectively analysed. There were 5 males and 7 females, aged 4 (range 0.45 to 9.00) years old, who developed hepaticojejunostomy strictures after cholangiectasis surgery and underwent reoperative treatment at Anhui Provincial Children's Hospital from January 2013 to January 2021. These patients were divided into the laparoscopic surgery group ( n=5) and the open surgery group ( n=7) based on the mode of reoperation. The children were followed-up by outpatient review and the relevant clinical data of the children in the 2 groups was analyzed. Results:The reoperations were completed successfully in the 2 groups. The maximum preoperative dilated common hepatic duct diameter was significantly larger in the laparoscopic group (1.26±0.23) cm than the open group (0.64±0.19) cm ( P<0.05). The alkaline phosphatase and glutamyltransferase levels in the laparoscopic surgery group were significantly lower before the operation (all P<0.05), and the total bilirubin, direct bilirubin, alkaline phosphatase, and glutamyltransferase levels were significantly lower in the laparotomy group than before the operations (all P<0.05). In the laparoscopic group, the time of the reoperations, postoperative hospital stay, and blood loss were 268(117, 340) min, (9.0±2.9) d and (14.0±5.5) ml, respectively, while those in the open group were 180(150, 205) min, (9.7±3.4) d and (13.3±2.6) ml, respectively. There were no significant differences between the two groups (all P>0.05). On follow-up, all children were well except for one child who showed mild elevation levels of alanine aminotransferase and aspartate aminotransferase. Conclusion:Laparoscopic surgery for hepaticojejunostomy strictures after cholangiectasis surgery in children was safe and feasible. Its curative effect was no less than that of open surgery.
