Clinical application of laparoscopy combined with choledochoscopy for children with congenital biliary dilatation
Objective:To investigate the clinical effect of laparoscopy combined with choledochoscopy in the surgical treatment of congenital biliary dilatation in children.Methods:The clinical data of 98 children with congenital biliary dilatation who underwent laparoscopic radical surgery from Dec.2019 to Dec.2023 were collected and divided into three groups based on the intraoperative biliary examination methods.The laparoscopic group(n=38)only underwent laparoscopic surgery,the cholangiography group(n=28)under-went intraoperative cholangiography in laparoscopic surgery,and the choledochoscopy group(n=32)underwent choledochoscopy in laparoscopic surgery.All children underwent routine magnetic resonance cholangiopancreatography before surgery.The collected data included gender,age,cyst type,cyst diameter,cyst length,presence of stones and bile duct abnormalities detected in preoperative mag-netic resonance cholangiopancreatography,identification of new stones during surgery,bile duct variations,bile duct stenosis,postopera-tive bile leakage,cholangitis,pancreatitis,and anastomotic stenosis.Results:There were no significant differences in gender,age,cyst diameter,cyst length,cyst type,stones and biliary tract abnormalities found by preoperative magnetic resonance cholangiopancreatogra-phy among the three groups(P＞0.05).The choledochoscopy group found more new stones(28.1%,9/32),the cholangiography group detected more biliary variations(21.4%,6/28),the differences were statistically significant(P＜0.05).The total complication rate differed among the three groups(P＜0.05),the choledochoscopy group had the lowest postoperative complication rate(3.1%,1/32).Conclusions:Laparoscopy combined with choledochoscopy can detect more"missed"stones with lower postoperative complication rates,while avoiding the risk of radiation exposure in children,which is worthy of further application in clinical practice.
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