腹腔镜下胆总管探查一期缝合的临床应用

CLINICAL APPLICATION OF COMMON BILE DUCT ECPLORATION UNDER LAPAROSCOPY WITH ONE-STAGE SUTURE

目的探讨腹腔镜下胆总管探查一期缝合的可行性、手术方法及技巧。方法对我院1999~2006年10月实施的43例腹腔镜联合胆道镜进行胆总管探查并一期缝合的患者资料进行回顾性分析并分析治疗效果。结果平均手术时间65±20 min,术中平均出血30.5±25 ml。并发症3例,其中胆漏2例,腹腔内出血1例。平均住院时间6.8±5.0 d,随访2 m^6 y,未见胆道残余结石及胆管狭窄。结论腹腔镜下胆总管探查一期缝合疗效确切,具有住院时间短,痛苦少,恢复快的优点,是一种安全有效的方法,值得推广。

Objective To ascertainth feasibility and to investigate the way and skill of common bile duct exploration under laparoscopy with one-stage suture. Methods Retrospective analyzed 43 patients who underwent common bile duct exploration with one-stage sutrue by laparoscopy and choledochofiberscopy from 1999.10 to 2006. 10,then valued the clinic therapeutic effect. Results Average operating time was 65 ± 20 min and average blood loss was 30. 5 ± 25 ml. Complications included：intraperitoneal bleeding （1 cases）, bile leakage（ 2 cases）. Mean operative hospital stay was 6. 8 ± 5.0 days. The patients were followed up for 2 months - 6 years and no biliary duct stricture or the remained bile stones in bile duct. Conclusion It is concluded that common bile duct exploration under laparoscopy with one-stage suture was provided with lesser operative trauma and more rapid recovery with minimal uneasmess of the patients. So that, these advanced operative procedures can be extended and popularized.