[1]魏延栋 王莹 马立霜** 冯翠竹 张艳霞 刘超 吴涛 李景娜.三孔法腹腔镜十二指肠菱形吻合术治疗61例新生儿先天性环状胰腺[J].中国微创外科杂志,2024,01(6):422-426.
　Wei Yandong,Wang Ying,Ma Lishuang,et al.Threeport Laparoscopic Rhombic Duodenal Anastomosis in the Treatment of Congenital Annular Pancreas in 61 Neonates[J].Chinese Journal of Minimally Invasive Surgery,2024,01(6):422-426.
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三孔法腹腔镜十二指肠菱形吻合术治疗61例新生儿先天性环状胰腺()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年6期
页码:
422-426
栏目:
临床研究
出版日期:
2024-06-25

文章信息/Info

Title:
Threeport Laparoscopic Rhombic Duodenal Anastomosis in the Treatment of Congenital Annular Pancreas in 61 Neonates
作者:
魏延栋 王莹 马立霜** 冯翠竹 张艳霞 刘超 吴涛 李景娜
(首都儿科研究所附属儿童医院新生儿外科，北京100020)
Author(s):
Wei Yandong;  Wang Ying;  Ma Lishuang;  et al.
Department of Neonatal Surgery, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
关键词:
腹腔镜; 新生儿; 环状胰腺
Keywords:
Laparoscopic surgery; Neonates; Annular pancreas
文献标志码:
A
摘要:
目的探讨腹腔镜手术治疗新生儿先天性环状胰腺的安全性和可行性。方法2015年6月~2023年6月我们对61例新生儿先天性环状胰腺采用三孔法腹腔镜手术，腹腔镜下分别游离环状胰腺远近端十二指肠，将十二指肠悬吊，近端扩张十二指肠横行切开，远端狭窄部分纵行切开，50 PDS 线连续缝合十二指肠前后壁。结果3例中转开腹手术，余58例腹腔镜下完成手术。手术时间60~324 min，(163±57)min。术后经口开始喂养时间3~15 d，(6.8±2.9)d。住院时间4～83 d，中位时间17 d。1例术后12 d因肠粘连梗阻，行腹腔镜下肠粘连松解。1例术后3 d出现吻合口漏，行腹腔镜下修补。1例伴有早产，低出生体重，术后73 d出现重症感染、休克、弥散性血管内凝血，家属放弃治疗后死亡；余60例均治愈出院。60例术后胰腺超声见胰腺形态可，胰管无扩张，胆管无扩张，无胰腺炎。60例随访时间1~96 个月，中位数37个月，均生长发育良好。结论腹腔镜手术治疗新生儿先天性环状胰腺是安全、可行的，对于早产儿、低出生体重儿围术期需精细化管理。
Abstract:
ObjectiveTo explore the safety and feasibility of laparoscopic surgery for congenital annular pancreas in neonates. MethodsFrom June 2015 to June 2023, a total of 61 neonates with congenital annular pancreas were treated with threeport laparoscopic surgery. Under the laparoscope, the proximal and distal segments of the duodenum around the annular pancreas were freed. The duodenum was then suspended, and a transverse incision was made in the dilated proximal duodenum while a longitudinal incision was made in the narrowed distal part. Continuous suturing of the anterior and posterior walls of the duodenum was performed with 50 PDS sutures.ResultsThree cases were converted to open surgery, while the remaining 58 cases were completed under laparoscope. The duration of surgery ranged 60-324 min, with an average of (163±57) min. The time to start oral feeding after surgery ranged 3-15 d, with an average of (6.8±2.9) d. The length of hospital stay varied 4-83 d, with a median of 17 d. One case experienced intestinal adhesive obstruction at 12 d after surgery, and underwent laparoscopic adhesion release. One case developed anastomotic leakage at 3 d after surgery and underwent laparoscopic repair. One case with prematurity and low birth weight developed severe infection, shock, and disseminated intravascular coagulation at 73 d after surgery, and died after the family decided to discontinue treatment. The remaining 60 cases were discharged after successful treatment. All the 60 patients were regularly followed up for 1-96 months, with a median of 37 months, having a good growth and development.ConclusionsLaparoscopic surgery in the treatment of congenital annular pancreas in neonates is safe and feasible. Refined management is required during the perioperative period for premature and low birth weight infants.

参考文献/References:

[1]Alkhayyat M, Bachour S, Abou Saleh M, et al. The epidemiology of annular pancreas in the United States: A populationbased study. J Clin Gastroenterol,2022,56(2):186-191.
[2]Etienne D, John A, Menias CO, et al. Annular pancreas: a review of its molecular embryology, genetic basis and clinical considerations. Ann Anat,2012,194(5):422-428.
[3]Pansini M, Magerkurth O, Haecker FM, et al. Annular pancreas associated with duodenal obstruction. BMJ Case Rep,2012,2012:bcr2012006855.
[4]韩厚美,盛璇,刘德泉,等.产前超声对胎儿环状胰腺的诊断价值.中华医学超声杂志(电子版),2023,20(1):46-50.
[5]杨博洋,周路遥,钟微,等.高回声环对新生儿环状胰腺的诊断价值.广州医科大学学报,2020,48(4):29-32.
[6]Zyromski NJ, Sandoval JA, Pitt HA, et al. Annular pancreas: dramatic differences between children and adults. J Am Coll Surg,2008,206(5):1019-1025.
[7]张悦,马继东,张艳霞,等.36例新生儿环状胰腺的诊治分析.北京医学,2016,38(8):792-794.
[8]李炳,陈卫兵,王寿青,等.腹腔镜下十二指肠菱形吻合术治疗新生儿环状胰腺二例.中华小儿外科杂志,2013,34(10):796-797.
[9]冯翠竹,李龙,马继东,等.腹腔镜与开腹手术治疗新生儿环状胰腺的对比研究.中国微创外科杂志,2017,17(11):1001-1003.
[10]吕成杰,钭金法,黄寿奖,等.新生儿十二指肠梗阻腹腔镜手术围术期并发症探讨.临床小儿外科杂志,2016,15(5):460-463.
[11]王莹,马丽霜,张艳霞,等.腹腔镜诊治新生儿先天性十二指肠梗阻54例.中国微创外科杂志,2021,21(6):495-499.
[12]王林燕,薛佳金,陈益,等.新生儿环状胰腺的临床诊治分析.浙江大学学报(医学版),2019,48(5):481-486.
[13]Wang D, Kang Q, Shi S, et al. Annular pancreas in China: 9 years’ experience from a single center. Pediatr Surg Int,2018,34(8):823-827.
[14]沈淳,郑珊,肖现民.低体重出生儿的手术预后因素观察.中华小儿外科杂志,2001,22(6):328-330.
[15]郝发宝.新生儿环状胰腺的临床诊疗进展.临床小儿外科杂志,2018,17(11):872-875.
[16]Yigiter M, Yildiz A, Firinci B, et al. Annular pancreas in children: a decade of experience. Eurasian J Med,2010,42(3):116-119.
[17]GutiérrezGonzález JA, González De La Torre E, ArmijoBorjón EA, et al. Annular pancreas as a cause of neonatal duodenal obstruction, a case report. J Surg Case Rep,2023,2023(7):rjad407.
[18]Ahmetgjekaj I, Roy P, Hyseni F, et al. Annular pancreas: Beneath the intestinal obstruction-A case report. Radiol Case Rep,2023,18(3):1364-1367.
[19]汪学艳,白琪,冯泽东,等.环状胰腺诊治进展.中华肝脏外科手术学电子杂志,2020,9(3):216-220.
[20]Jimenez JC, Emil S, Podnos Y, et al. Annular pancreas in children: a recent decade’s experience. J Pediatr Surg,2004,39(11):1654-1657.
[21]Ali Almoamin HH, Kadhem SH, Saleh AM. Annular pancreas in neonates; Case series and review of literatures. Afr J Paediatr Surg,2022,19(2):97-101.

备注/Memo

备注/Memo:
基金项目：北京市高层次公共卫生技术人才培养计划（学科骨干-01-034）**通讯作者，Email：malishuang2006@sina.com
更新日期/Last Update: 2024-09-03