Comparison Of Therapeutic Effects Between Open And Laparoscopic Surgery For Congenital Choledochal Cyst In Children

Objective:Congenital is a kind of extrahepatic bile duct dilatation of the bile duct to the characteristics of children with congenital malformations,should be early radical surgical removal of the cyst after diagnosis.At present,the widely accepted operative method at home and abroad is choledochal cyst resection,hepatojejunojejunostomy(roux-y).With the development of minimally invasive technique,laparoscopic radical choledochal cyst surgery has been developed rapidly.This article analyzes the clinical data of children with common bile duct cysts treated with these two different surgical methods,and compares the efficacy and postoperative complications of conventional open and laparoscopic radical cholecystectomy.Materials and Methods:By collecting clinical data of 117 children with congenital choledochal cysts who were treated by pediatric surgery at the First Affiliated Hospital of Zhengzhou University from November 2015 to November 2017,they were divided into open common bile duct cysts according to the different surgical methods.Fifty-nine patients underwent hepaticojejunal Roux-Y anastomosis(OP group)and 58 cases underwent laparoscopic cholecystectomy and Roux-Y anastomosis(LP group).The clinical data of the two groups were analyzed by spss21.0 software,such as general condition,examination method,type of choledochal cyst,time of operation,amount of blood loss during operation and complications after operation.To compare the characteristics and efficacy of two surgical methods in the treatment of choledochal cyst.Results:From November 2015 to November 2017,a total of 117 children with congenital choledochal cysts were treated with pediatric surgery at the First Affiliated Hospital of Zhengzhou University.According to the Todani classification,73 cases of type I common bile duct cysts,IVA type common bile duct 44 cysts,male to female ratio 36/81(n = 36 for males,n = 81 for females).All patients underwent B-ultrasound before surgery,78 patients underwent MRCP examination,and 39 patients underwent MR examination.CT examination revealed 117 cases of abdominal pain in 72 children,53 cases of vomiting,39 cases of yellow staining and white stools,and 7 cases of colorectal ultrasound findings during maternal physical examination.39 patients admitted to hospital can touch the right upper abdominal mass.The operation time was 213.05±20.47 min in the OP group and 220.48±15.06 min in the LP group(P<0.05);the intraoperative blood loss in the OP group was 20.76±7.12 ml,and the intraoperative blood loss in the LP group was 13.79±6.83ml(P <0.05);The postoperative defecation time was 2.79±0.63 days in the OP group,and 2.44±0.56 days in the LP group(P<0.05);the oral intake time in the OP group was 4.15±0.69 days;The oral feeding time was 3.72±0.72 days in the LP group.(P<0.05);the postoperative hospital stay was 11.22±1.72 days in the OP group and 9.12±1.81 days in the LP group(P<0.05);The difference in postoperative complications was not statistically significant(P>0.05).The LP group was divided into two groups according to the age at the time of surgery.One group was a group with a monthly age of 36 and one group was a group with a monthly age of 36.The data of the two groups included intraoperative blood loss,operation time,postoperative defecation time,and postoperative oral feeding.There was no difference in length of time and postoperative hospital stay(P>0.05).Conclusions:1.Roux-Y anastomosis of hepatic jejunostomy by laparoscopic common bile duct cyst has the advantages of less intraoperative blood loss,shorter postoperative recovery time of gastrointestinal tract function and shorter postoperative hospital stay than traditional open surgery.2.Laparoscopic radical choledochocystectomy is safe and effective for children younger than 36 months of age.The risk of surgery and postoperative recovery delay do not increase with the age of the child.