腹腔镜胆总管探查一期缝合的临床运用

The clinical application of the primary suture of common bile duct after laparoscopic common bile duct exploration

目的:探讨腹腔镜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2002年2月～2008年10月实施的48例腹腔镜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(85±20)min,术中平均出血(30±15)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(6.3±4.0)d,随访4个月～6年,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 explore feasibility and to investigate the way and skill of common bile duct exploration under laparoscopy with primary suture. Methods： Retrospectively, the therapeutic efficacy of 48 patients with the indications of exploration of common bile duct were analyzed and all the cases were subjected to primary suture after laparoscopic common bile duct exploration. Results： All 48 cases were cured. Average operating time was （85±20） rain and average blood loss was （30±15） ml. Complications included intraperitoneal bleeding （1 cases）, bile leakage （2 cases）. Mean operative hospital stay was （6.3±4.0） days. The patients were followed up for 4 months - 6 years and no biliary duct stricture or the remained bile stones in bile duct. Conclusion： ff the indication is properly mastered, the primary suture exploration of common bile duct can be safe and feasible after laparoscopic common bile duct exploration.