腹腔镜下胆总管探查一期缝合的临床应用研究

Study on the One-stage Suture of Common Bile Duct Exploration under Laparoscopy

目的探讨腹腔镜下胆总管探查一期缝合的可行性、手术方法及技巧。方法对该院2009年6月—2011年6月的78例腹腔镜联合胆道镜进行胆总管探查手术,其中12例采用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(70±20)min,术中平均出血10～60 mL。并发症2例,均为胆漏。平均住院时间(7.0±2.0)d,随访2 m～2 y,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,是一种安全有效的方法,值得推广。

Objective To investigate the feasibility, method, and skill of one-stage suture of common bile duct exploration under laparoscopy. Methods Of the 78 patients underwent common bile duct exploration under laparoscopy and choledochoscope in our hospital from June, 2009 to June, 2011, 12 patients were treated with one-stage suture, the data of them and the effects of onestage suture were analyzed retrospectively. Results Of the 12 patients, the average operation time was 70卤20 min,average intraoperative blood loss was 10锝？0ml, and average length of stay was 7.0卤2.0 d. 2 cases of complications were biliary leakage. The patients were followed up from 2 months to 2 years, and no residual biliary tract stones and bile duct stenosis were found. Conclusion The one-stage suture of common bile duct exploration under laparoscopy is a safe and effective operation method with shorter length of stay, less pain and more rapid recovery, which is worthy of promotion.