腹腔镜胆总管切开探查术后一期缝合术的临床安全性分析

The Clinical Safety of Primary Closure after Laparoscopic Common Bile Duct Exploration:a Report of 165 Cases

目的分析腹腔镜胆总管切开探查取石一期缝合术的临床用价值与安全性.方法分析我院2004年1月至2009年3月腹腔镜165例胆总管切开探查术的临床疗效,其中腹腔镜胆总管一期缝合术共76例,胆总管切开探查取石T管引流术89例的临床疗效.结果两组在手术时间、腹腔引流管引流时间、胆漏、残石率等情况差异无统计学意义(P>0.05),一期缝合组术后住院时间及输液量比引流组差异有统计学意义(P<0.05).结论缝合组比引流组住院时间更短、输液量更少,腹腔镜胆总管切开探查取石一期缝合术是一种安全较简便经济的手术方法.

Objective To analyse the clinical value and safety of laparoscopic common bile duct exploration （LCDE）. Methods The clinical data of 105 cases by common bite duct exploration （CBDE） from January 2005 to March 2009 were analyzed, 76 cases were operated by LCDE in 165 cases, 89 cases were operated by CBED in 105 cases. Results There was no significant difference in terms of operation time, abdominal drainage time, postoperative bite leakage retained bile duct stones, bile duct recurrent stones between the two groups （ P 〉 0.05 ）. There was significant difference in terms of postoperative hospital stay and fluid replacement between the two groups （P〈 0.05）, postoperative hospital stay was shorter and fluid replacement was less in closure group than that in drainage group. Conclusion Primary closure after laparoscopic common bile duct exploration is safe, easy and economic.