腹部手术后腹腔镜胆总管探查的临床体会

Clinical experience of laparoscopic common bile duct exploration in patients with abdominal surgery history

目的探讨有腹部手术史患者再次行腹腔镜胆总管探查的可行性及临床疗效。方法回顾分析2002年1月～2007年1月施行的有腹部手术史的68例腹腔镜胆总管探查病例(A组),并随机选择同期进行无腹部手术史的68例腹腔镜胆总管探查病例(B组)进行比较。结果A组有1例中转开腹,B组均无中转开腹,平均手术时间A组(118.6±25.5)min,B组(87.4±16.4)min,P<0.05。平均住院天数A组(8.12±0.61)d,B组(7.86±0.48)d,P>0.05。两组病例均无腹腔脏器损伤并发症。结论对多数有腹部手术史的患者来说,腹腔镜胆总管探查术是有效、可行、微创的方法。

[Objective] To discuss the feasibility and clinical efficacy of laparoscopic common bile duct exploration in patients with abdominal surgery history. [Methods] A retrospective analysis was conducted on 68 patient who had history of prior abdominal surgery and underwent laparoscopic exploration of common bile duct from Jan 2002 to Jan 2007 （group A）, and another 68 patients （group B） who had no history of prior abdominal surgery but underwent laparoscopic exploration of common bile duct synchronously were randomly selected as control. [Results] One case in group A but none in group B were converted to open surgery. The average duration of operation for group A and group B were （118.6±25.5） min and （87.4±16.4） rain respectively （P〈0.05）, and the median length of hospital stay was （8.12±0.61） d and （7.86±0.48） d （P〉0.05）. No intraabdominal visceral injury was found. [Conclusion] Laparoscopic common bile duct exploration is an effective, feasible and minimally-invasive procedure for most of the patients with abdominal surgery history.