CAJ | 학술논문

目的：总结腹腔镜治疗肝外胆总管囊肿中转开腹手术的经验，分析中转开腹手术的原因。方法2009年6月至2013年9月我们收治144例先天性肝外胆总管囊肿（CECC）患儿，其中36例中转开腹手术患儿作为病例组，108例腹腔镜手术成功患儿作为对照组，采用单因素分析模型及多因素分析模型分析腹腔镜胆总管囊肿根治术中转开腹的危险因素。结果有上腹部手术史，肝管直径≤3 mm，胆总管囊肿壁厚度＞4 mm，囊肿直径＞5 cm 可能是影响腹腔镜技术治疗 CECC 导致中转开腹手术的显著因素（P ＜0．05）。结论临床医生在采取腹腔镜技术治疗 CECC 时，术前综合评估患儿进而选择手术方案，对降低腹腔镜治疗 CECC 中转开腹率具有重要的临床意义。
목적：총결복강경치료간외담총관낭종중전개복수술적경험，분석중전개복수술적원인。방법2009년6월지2013년9월아문수치144례선천성간외담총관낭종（CECC）환인，기중36례중전개복수술환인작위병례조，108례복강경수술성공환인작위대조조，채용단인소분석모형급다인소분석모형분석복강경담총관낭종근치술중전개복적위험인소。결과유상복부수술사，간관직경≤3 mm，담총관낭종벽후도＞4 mm，낭종직경＞5 cm 가능시영향복강경기술치료 CECC 도치중전개복수술적현저인소（P ＜0．05）。결론림상의생재채취복강경기술치료 CECC 시，술전종합평고환인진이선택수술방안，대강저복강경치료 CECC 중전개복솔구유중요적림상의의。
Objetive Analysis on risk factors of conversion to laparotomy from laparoscopy in the treat-ment of extrahepatic bile duct cyst.Methods 205 cases of 2009 06 to 2013 09 congenital extrahepatic bile duct cyst (CECC)children underwent laparoscopic operation treated were chosen,who were selected in 2009 May (after laparoscopic technology is relatively mature)including 36 cases of laparotomy patients as case group,108 cases of laparoscopic operation patients as the control group.The risk factors of conversion were an-alyzed using univariate and multivariate models.Results History of upper abdominal operation,hepatic duct diameter ≤3 mm,choledochal cyst wall thickness >4 mm,cyst diameter >5 cm may be significant factors af-fecting laparoscopic treatment of CECC leads to conversion to laparotomy(P <0.05). Conclusions Pediatric surgeons should carefully assess children and then select the operation scheme preoperatively.This is of impor-tant clinical significance for reducing the rate of conversion to laparotomy from laparoscopic treatment of CECC.