腹腔镜胆总管探查一期缝合术2740例报告

Primary closure of common bile duct after laparoscopic bile duct exploration:a report of 2740 patients

目的总结腹腔镜胆总管探查一期缝合术的治疗经验。方法回顾性分析1992年6月至2018年3月成都市第二人民医院行腹腔镜胆总管探查一期缝合术的2740例患者资料,总结治疗效果及经验。结果一期缝合的2740例患者中,有2534例(92.5%)腹腔镜手术获成功,中转开腹一期缝合成功15例(0.6%)。术后胆汁漏113例(4.1%),残石29例(1.1%),1例胰腺癌术后15天死亡(0.1%),其他并发症48例(1.8%),总并发症发生率为7.0%(191/2740)。结论只要选择合适的患者,腹腔镜胆总管探查一期缝合术是有效且安全可行的。

Objective To analyze our experience in primary closure of common bile duct after laparoscopic bile duct exploration.Methods From June 1992 to March 2018,2740 patients underwent primary closure of common bile duct after laparoscopic common bile duct exploration in the Second People's Hospital of Chengdu.Results The operations were successfully carried out in 2534(92.4%)out of 2740 patients, of whom 15 patients (0.6%)were converted to open common bile duet exploration.Bile leakage occurred in 113 patients (4.1%).Residual stones were found in 29 patients (1.1%).One patient (0.1%)who had a pancreatic carcinoma died on postoperation day 15.48 patients (1.8%)developed other complications.The total postoperative complication rate was 7.0%(191/2740).Conclusion In suitable patients,laparoscopic bile duct exploration with primary closure was feasible,safe and effective.