腹腔镜胆总管切开一期缝合术的临床应用

Clinial analysis of laparoscopic common bile duct primary suture

目的探讨腹腔镜胆总管切开取石后一期缝合术治疗胆总管结石的可行性。方法对2003年2月至2010年11月实施的50例腹腔镜胆总管探查并一期缝合的患者资料进行分析。结果平均手术时间105min,术中平均出血量35ml,其中胆瘘1例,腹腔内出血1例,平均住院时间5d,术后随访6个月～4年,未见胆道残余及胆管狭窄。结论胆总管一期缝合术治疗胆总管结石安全有效、患者痛苦小、术后恢复快,用腹腔镜行此手术更具有微创的优点,值得推广。

Objective To explore the feasibility of primary duct closure after laparoscopic common bile duct exploration. Methods We restrospectively analyzed the clinical date of primary duct closure after laparoscopic common bile duct exploration on 50 cases between February 2003 and November 2010. Results . There was no case of retain stones after operation. There was 1 case of biliary fistula and 1 case of bleeding in enterocodia. The mean operation time was 105 minutes. The mean bleeding volume was 35ml. The patients were discharged from our hospital with a mean of 5 days. The patients received a follow-up for 6 months to 4 years, during which no residual and bile duct stricture. Conclusions The primary duct closure after laparoscopic common bile duct exploration had numerous advantages. It is safe and feasible and can help patients rapid recorery.