摘要
目的探讨腹腔镜下胆总管切开取石一期缝合安全性及可行性。方法回顾性分析2010年3月至2015年10月中山大学孙逸仙纪念医院腹腔镜下胆总管切开取石185例患者的临床资料,根据胆总管切口不同处理方式分为一期缝合组和T管引流组,观察两组手术时间、术中出血量、术后住院时间、术后并发症等指标。结果两组手术均获成功,无中转开腹。一期缝合组和T管引流组手术时间、术中出血量、术后并发症比较,差异无统计学意义(P>0.05)。一期缝合组术后住院时间较T管引流组明显缩短(P<0.01),两组术后随访未见结石复发及胆道狭窄。结论严格把握手术的适应证,选择正确缝合材料,具备娴熟的操作技能,腹腔镜下胆总管切开取石一期缝合是安全可行性的,能避免放置T管相关并发症风险,术后住院时间短、生活质量提高。
Objective To explore the feasibility and safety of primary suture in laparoscopic common bile duct exploration （LCBDE） for treating choledocholithiasis. Methods The clinical data in 185 cases of choledocholithiasis underwent LCBDE in Sun Yat-sen Memorial Hospital from March 2010 to October 2015 were retrospectively analyzed. The patients were divided into laparoscopic common bile duct exploration and primary suture（LBEPS） group（liT cases） and T tube drainage group（68 cases） ac- cording to different processing modes of common bile duct incision. The operative time,intra-operative blood loss amount and post- operative complications were observed in the two groups. Results All operations were successfully performed in both two groups without converting to laparotomy. The operative time,intra-operative blood loss amounts and postoperative complications had no statistically significant differences between the LBEPS group and T tube drainage group（P^0.05）. The postoperative hospital stay of the LBEPS group was significantly shorter than that of the T tube drainage group（P^0.01）. There was no bile duct stricture or stone recurrence during the follow up period in the two groups. Conclusion Under strictly grasping the operation indication, selec- ting correct suture material and possessing practiced operating skills, primary suture of laparoscopic choledocholithiasis is safe and feasible,can avoid the risk of T tube placing related complications, has short postoperative hospitalization duration and increases postoperative living quality.
出处
《重庆医学》
CAS
北大核心
2017年第20期2780-2781,2785,共3页
Chongqing medicine
关键词
腹腔镜
胆总管结石
一期缝合
laparoscopy
choledocholithiasis
primary suture
