Three-port Laparoscopic Rhombic Duodenal Anastomosis in the Treatment of Congenital Annular Pancreas in 61 Neonates
Objective To explore the safety and feasibility of laparoscopic surgery for congenital annular pancreas in neonates.Methods From 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.Results Three 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.Conclusions Laparoscopic 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.
万方数据
维普
