CAJ | 학술논문

目的：探讨双半圆单层连续缝合法在腹腔镜胆肠吻合术中的可行性与安全性。方法2001年10月～2009年10月，218例先天性胆总管囊肿患儿接受腹腔镜Roux-en-Y肝管空肠吻合术。腹腔镜下游离切除胆总管囊肿，空肠Roux支采用体外手工吻合完成，最后腹腔镜下“双半圆”连续缝合方式完成肝管空肠端-侧吻合。结果218例均顺利完成手术，胆肠吻合时间60～100 min，平均70 min，术后住院时间（7．4±2．4）d。胆漏2例（术后10天自愈）。术后随访12～102个月，中位数38个月，未见胆道残余及胆管狭窄。结论双半圆单层连续缝合法应用于腹腔镜胆总管囊肿根治术是安全可行的。该缝合方式操作简便，值得推广。
목적：탐토쌍반원단층련속봉합법재복강경담장문합술중적가행성여안전성。방법2001년10월～2009년10월，218례선천성담총관낭종환인접수복강경Roux-en-Y간관공장문합술。복강경하유리절제담총관낭종，공장Roux지채용체외수공문합완성，최후복강경하“쌍반원”련속봉합방식완성간관공장단-측문합。결과218례균순리완성수술，담장문합시간60～100 min，평균70 min，술후주원시간（7．4±2．4）d。담루2례（술후10천자유）。술후수방12～102개월，중위수38개월，미견담도잔여급담관협착。결론쌍반원단층련속봉합법응용우복강경담총관낭종근치술시안전가행적。해봉합방식조작간편，치득추엄。
Objective To evaluate the feasibility and effectiveness of double-hemicircumferential running suture in laparoscopic cholangiojejunostomy for choledochal cysts. Methods From October 2001 to October 2009, we performed Roux-en-Y hepaticojejunostomy in 218 children with congenital choledochal cysts. The choledochal cysts were excised laparoscopically. The jejunal Roux loop was sutured extracorporeally by using hand-suturing technique. Laparoscopic "double-hemicircumferential"end-to-side anastomosis between the common hepatic duct stump and Roux loop was carried out. Results The reconstruction with this type of single-layer running suture was successfully completed in all the 218 children.The anastomosis time was 60-100 min ( mean, 70 min).The postoperative hospital stay was (7.4 ±2.4) days.Two patients developed a bile leakage which stopped spontaneously after 10 days of drainage.The follow-up period was 12-102 months (median, 38 months).During the follow-up observations, no biliary stenosis or cholangitis occurred. Conclusion Double-hemicircumferential running suture technique has the advantages of simple performance ,short operation time, and less complications, being an effective and feasible improvement of cholangiojejunostomy.