腹腔镜胆总管探查一期缝合的临床分析

Clinial analysis of laparoscopic common bile ductexploration with primary suture

目的探讨腹腔镜胆总管探查术胆总管一期缝合的治疗方法及效果。方法 2005年12月～2011年12月,对446例胆囊结石并胆总管结石的患者采用腹腔镜胆总管探查术一期缝合胆总管的方法治疗。结果手术获成功426例(95.5%),胆管阴性探查14例(3.1%),中转开腹手术6例(1.3%),术后胆漏48例(10.7%),全组病例无围手术期死亡及术后胆道残石发生。420例随访(4±0.3)年,无胆管狭窄。结论腹腔镜胆总管探查术一期缝合胆总管是安全可行的。

Objective To explore the therapeutic methods and efficacy of primary duct closure after laparoscopic common bile duct exploration.Methods In 2005 December^2011 year in December,446 cases of cholecystolithiasis and choledocholithiasis patients were treatmented with laparoscopic common bile duct exploration and primary suture of common bile duct.Results Primary closure was achieved in 426 cases（95.5%）,there were 14 cases exploration with negative results（3.1%）,6 cases conversion to open surger（1.3%）,48 cases intraperitoneal leakage of bile after operation（10.7%）,of all the cases,there was no perioperitive death and residual.None of 420 cases was found postoperative bile duct stricture in follow-up（4±0.3）years.Conclusion It is safe and feasible that the primary duct closure after laparoscopic common bile duct exploration.