摘要
目的:探讨腹腔镜胆总管一期缝合术在胆总管结石外科治疗中的应用价值。方法:回顾性分析2015年1月—2018年12月在本院实施腹腔镜下胆总管切开取石的70例患者的临床资料,分成一期缝合组30例、T管引流组40例,比较两组的临床疗效。结果:两组均顺利完成腹腔镜手术,两组术后并发症发生率、结石复发率均无统计学意义(P>0.05);一期缝合组手术时间、住院时间(术后)、肠功能恢复时间、腹腔引流管拔除时间均短于T管引流组,两组差异有统计学意义(P<0.05)。一期缝合组术后并发胆漏2例,T管引流组胆漏3例,经4~6d充分引流后胆漏自行消失,均未发生胆汁性腹膜炎等严重并发症。结论:腹腔镜胆总管一期缝合术应用于合适的患者,能够获得最大程度的微创,取得近似腹腔镜胆囊切除术的效果,具有临床应用价值。
Objective:To evaluate the value of laparoscopic one-stage choledocholithiasis suture in the surgical treatment of choledocholithiasis.Methods:Retrospective analysis was performed on the clinical data of 70 cases of laparoscopic choledocholithotomy performed in our hospital from January 2015 to December 2018,which were divided into two groups:30 cases in the one-stage suture group and 40 cases in the T-tube drainage group,and the clinical efficacy of the two groups was compared.Results:Laparoscopic surgery was successfully completed in both groups,and the incidence of postoperative complications and recurrence rate of stones were not statistically significant in both groups(P>0.05).The operation time,hospitalization time(postoperative),recovery time of intestinal function and extraction time of abdominal drainage tube in the one-stage suture group were all shorter than those in the T-tube drainage group,and the differences between the two suture groups were statistically significant(P<0.05).Postoperative complications were bile leakage in the one-stage suture group,including 2 cases of bile leakage and 3 cases of bile leakage in the T-tube drainage group.After 4~6 days of full drainage,the bile leakage disappeared without any serious complications such as biliary peritonitis.Conclusion:Laparoscopic one-stage choledochal suture can be applied to suitable patients,so that patients can obtain the maximum degree of minimally invasive,and obtain the effect similar to laparoscopic cholecystectomy,which has clinical application value.
作者
蔡军
张彤
王翔
CAI Jun;ZHANG Tong;WANG Xiang(Department of Hepatobiliary and Pancreatic Surgery,Xinghua people’s Hospital,Jiangsu Province 225700)
出处
《医学理论与实践》
2020年第1期17-19,共3页
The Journal of Medical Theory and Practice
基金
江苏大学医学临床科技发展基金项目资助(JLY20160164)
泰州市科技支撑社会发展计划项目(泰科技[2017]20号)
关键词
胆总管结石
一期缝合
T管引流
腹腔镜
Choledocholithiasis
One-stage suture
T-tube drainage
Laparoscopy
