摘要
目的探讨腹腔镜胆总管切开探查术(laparoscopic common bile duct exploration,LCBDE)后胆管一期缝合的可行性及适应证。方法回顾性分析我院2002年6月至2008年5月成功施行LCBDE79例的临床资料,比较胆管一期缝合26例(缝合组)与T管引流53例(引流组)的临床疗效。结果手术时间和总并发症发生率两组间差异无统计学意义(P>0.05),缝合组的住院费用、术后住院时间和恢复工作时间明显少于引流组(P<0.05或P<0.01)。缝合组胆漏2例,无结石残留;引流组胆漏3例,结石残留1例。引流组拔T管引起胆漏并胆汁性腹膜炎2例。随访期间两组均无胆管狭窄和结石复发。结论LCBDE一期缝合与T管引流相比,住院费用少,术后住院时间短,恢复快,安全可行,但必须严格掌握适应证。
Objective To investigate the feasibility and indications of primary closure after laparoscopic common bile duct exploration（LCBDE）. Methods We retrospectively analyzed the clinical data of LCBDE for common bile duct（CBD） stones performed on 79 cases between June 2002 and May 2008, of which 26 cases had closed CBD primarily （closure group）, and 53 cases had T-tube drainage of CBD （drainage group）. Results There was no statistically significant difference in operative time and total complication rate between the two groups（P〉0. 05）. Postoperative hospital stay was shorter and cost of hospitalization was less in closure group than in drainage group（P〈0. 05 or P〈0. 01）. Bile leakage occurred in 2 cases in closure group, and 3 cases in drainage group. There was no case of retained stones in closure group, and 1 case in drainage group. Bile peritonitis was found in 2 cases after T-tube removal. There was no case of postoperative extrahepatic duct stenosis and no recurrent stones in the two groups during the follow-up period. Conclusion Under the condition of strictly controlling the indications, primary closure of CBD after LCBDE for CBD stones is safe and feasible.
出处
《腹部外科》
2009年第5期278-280,共3页
Journal of Abdominal Surgery
关键词
腹腔镜检查
胆总管
胆石
治疗结果
Laparoscopy
Common bile duct
Gallstones
Treatment outcome
