摘要
目的 探讨腹腔镜联合尿道镜微创保胆取石术治疗小儿胆囊结石的方法及临床应用价值。方法 回顾性分析本院2009年8月至2013年8月采用腹腔镜联合尿道镜微创保胆取石术治疗的20例胆囊结石患儿临床资料，男11例，女9例，年龄1岁1月至15岁，胆囊多发并泥沙样结石13例，单发结石3例，遗传性球形红细胞增多症并胆囊结石4例。结果 20例均顺利完成手术，手术时间30～90min，出血量5～20mL，无术中输血。4例遗传性球形红细胞增多症并胆囊结右患儿联合行腹腔镜下脾切除术。术后患儿临床症状基本消失，单纯胆囊结石患儿术后3d复查腹部彩超见结石无残留。随访6个月至4年，17例未发现胆囊结石复发；1例失访；1例术前大量泥沙样结石术后彩超可见少量结石残留，约0．1cm大小，无临床症状；1例术前提示胆囊萎缩，胆囊多发结石合并胆囊炎，术后1周患儿仍腹痛，彩超发现胆囊少量泥沙样结石，予胆囊造瘘术，术后1个月拔除造瘘管，随访半年未见结石复发。结论 腹腔镜联合尿道镜保胆取石术治疗小儿胆囊结石可保留胆囊功能，操作简单，术后恢复快、并发症少，复发率低，是治疗小儿胆囊结石的可行性方法。
Objective To evaluate the clinical value of minimally invasive laparoscopy combined with urethroscope in cholecystolithotomy with gallbladder preserved in the treatment of pediatric gallstone. Methods A retrospective review was made on the clinical data of 20 children with gallstone in our hospital from Aug. 2009 to Aug. 2013, who underwent minimally invasive laparoscopy combined with urethroscope cholecystolithotomy with gallbladder preserved. Among them, 11 patients were males and 9 were females with the age ranging from 1.1 to 15 years. Thirteen cases had multiple and muddy stones, 3 cases with a single stone, and 4 cases had gallbladder stones combined with hereditary spherocytosis. Results The operations of all patients were completed successfully. The operative time ranged from 30 to 90 mins. There was no blood transfusion during the operation. The follow-up time was from 6 months to 4 years. Most patients had no gallstone recurrence （ 17 of 20）. A small stone （ size 0.1 cm） in gallbladder was found in one patient with muddy stones after operation- without visible clinical symptoms. Few muddy stones were found in one patient with multiple gallbladder stones combined cholecystitis one week after the surgery, and the patient then underwent cholecystostomy. One case lost to follow-up. Conclusion Laparoseopy combined with urethroscope with gallbladder preserved in the treatment of pediatric gallstone can reserve gallbladder function, and the operation procedure is simple with rapid postoperative recovery and fewer complications. It is a feasible method for the treatment of gallstone in children.
出处
《临床小儿外科杂志》
CAS
2015年第1期51-53,共3页
Journal of Clinical Pediatric Surgery
关键词
腹腔镜
外科手术
胆囊结石病
儿童
Laparoscopes
Surgical Procedures, Operative
Cholecystolothiasis
Child
