保胆手术中胆囊壁浆肌层缝合的临床研究

Clinical studies on seromuscular anastomoses of gallbladder's wall

目的胆囊壁浆肌层缝合临床应用的可行性。方法分析2011年1月-2011年12月，该科因胆囊结石或胆囊息肉行保胆手术共40例的临床资料，其中行胆囊壁间断浆肌层缝合者20例，行胆囊壁间断全层缝合或双层缝合者20例。结果两组患者均手术成功，术后均无腹腔积液、发热及腹痛，随访半年无1例结石复发。结论①符合保胆条件者，保胆手术中浆肌层单层间断缝合与全层或双层缝合胆囊壁是安全可靠的缝合方式。②浆肌层单层间断缝合比全层或双层缝合操作更简单，切口修复后更规整。推荐用4-0或5-0的可吸收缝线行浆肌层单层间断缝合来修复胆囊壁。

[ Objective ] To determine the feasibility of seromuscular anastomosis of gallbladder＇s wall in clinical practice. [Methods] To analyze 40 cases after EGPCL （endoscopic gallbladder-preserving cholecystolithotomy） between January 2011 to December 2011.20 patients accepted seromuscular anastomoses of gallbladder＇s wall and 20 patients accepted whole-layer or double layer anastomoses. [ Results ] All patients were successful operation, no postoperative biliary fistula, fever and abdominal pain without a case of gallstone recurrence for half a year. [ Conclusions ] ①It is feasibility and safety to suture the gallbladder wall by seromuscular anastomosis and whole-layer or double layer anastomosis. ②The operation of seromuscular anastomosis is more easy than whole-layer or double layer anastomosis and it＇s incision is more neat.