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目的:探讨腹腔镜手术治疗成人Ⅳ型先天性胆管扩张症(CBD)的安全性和疗效。方法:回顾性分析湖南省人民医院2010年1月至2019年1月行完整囊肿切除+胆管空肠Roux-en-Y吻合术治疗的63例成人Ⅳ型CBD患者临床资料,其中腹腔镜组23例,开腹组40例。采用n t检验比较两组患者手术时间、术中出血量、术后排气时间和住院时间的差异,采用χn 2检验比较两组患者术后并发症的差异。n 结果:腹腔镜组23例成人Ⅳ型CBD患者,其中男性4例,女性19例,年龄(29.9±14.0)岁;开腹组40例,男性7例,女性33例,年龄(30.9±15.7)岁。腹腔镜组与开腹组患者手术时间分别为(207.1±21.7)min和(158.8±23.3)min,术中出血量分别为(189.6±150.5)ml和(266.0±119.5)ml,术后排气时间分别为(72.8±16.0)h和(87.0±17.0)h,术后住院时间分别为(9.8±3.2)d和(11.9±3.7)d,两组比较差异均有统计学意义(均n P0.05)。n 结论:腹腔镜下治疗成人Ⅳ型CBD安全可行,具有微创、出血量少、胃肠功能恢复较快、住院时间短等优点。“,”Objective:To study the safety and efficacy of laparoscopic surgery in treatment of adult type IV congenital biliary dilatation (CBD).Methods:The clinical data of 63 adult patients with type IV CBD who underwent complete cystectomy and Roux-en-Y choledochojejunostomy at Hunan Provincial People’s Hospital from January 2010 to January 2019 were retrospectively studied. There were 23 patients in the laparoscopy group and 40 patients in the laparotomy group. T-test was used statistically to compare the differences in operation time, intraoperative blood loss, postoperative time to fist flatus, and hospital stay between groups. Chi-square test was used to statistically compare postoperative complications between groups.Results:In the laparoscopy group, there were 4 males and 19 females, aged (29.9±14.0) years, while in the laparotomy group, there were 7 males and 33 females, aged (30.9±15.7) years old. The operation times of the laparoscopy and laparotomy groups were (207.1±21.7) min versus (158.8±23.3) min, respectively. The intraoperative bleeding volume was (189.6±150.5) ml versus (266.0±119.5) ml, respectively. The postoperative time to first flatus was (72.8±16.0) h versus (87.0±17.0) h respectively. The postoperative hospital stay was (9.8 ±3.2) d versus (11.9±3.7) d, respectively. There were significant differences between the two groups ( all n P0.05) .n Conclusions:Laparoscopic surgery to treat adult type IV CBD was safe and feasible. It had the advantages of minimal invasiveness, less bleeding, rapid recovery of gastrointestinal function, and a short hospital stay.