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腹腔镜胆总管探查一期缝合术的临床研究 被引量:1

The clinical study of primary suture of common bile duct in laparoscopic common bile duct exploration
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摘要 目的:探讨腹腔镜胆总管探查一期缝合术的可行性及临床应用价值。方法:2008年7月至2013年7月为137例患者行腹腔镜胆总管探查术,其中胆总管一期缝合67例(一期组),留置T管引流70例(T管组),对比两种术式的疗效。结果:一期组与T管组手术时间[(79±10)min vs.(92±12)min]、术后住院时间[(4.9±1.0)d vs.(7.1±1.4)d]、胆漏发生率(7 vs.1)差异有统计学意义(P<0.05)。两组术后无其他严重并发症发生及手术死亡病例。术后随访1年,B超、CT检查均未发现胆漏、胆管狭窄及结石复发。结论:腹腔镜胆总管探查术后选择性行胆总管一期缝合,避免了T管留置引起的一系列弊端,是安全、可行、有效的,值得推广应用。其主要风险为胆漏,但胆漏多为短期漏,通过引流可自愈。 Objective:To explore the feasibility and clinical application value of primary suture common bile duct (CBD) after laparoscopie common bile duct exploration (LCBDE). Methods :From Jul. 2008 to Jul. 2013,137 patients were performed LCBDE,the primary suture of the CBD after LCBDE (group primary suture) was successfully performed in 67 patients, in 70 cases the T tube was put into the CBD after LCBDE ( group T tube). The clinical effects of the 2 groups were retrospectively analyzed and compared. Re- stilts :The average time of the operation [ (79 ± 10 ) min vs. (92 ± 12 ) rain ] , the average of hospital stay after operation [ (4.9 ± 1.0 ) d vs. (7.1± 1.4) d], the bile leakage rate (7/67 vs. 1/70 ) were significantly different between the two groups (P 〈 0.05 ). No other serious complications or operation-related death occurred after operation in the 2 groups. During the follow-up of 1 year, no bile leakage, bile duct stenosis or recurrence of calculi were found by B-ultrasound and CT. Conclusions:The selective primary suture of CBD after LCBDE avoids disadvantages of T-tube,is safe ,feasible and effective ,worthy of clinical expansion. The main risk lies in bile leakage, but which is mostly short-term leakage, self-healing by drainage.
机构地区 余姚市人民医院
出处 《腹腔镜外科杂志》 2014年第11期870-872,共3页 Journal of Laparoscopic Surgery
关键词 胆总管结石 胆总管一期缝合术 腹腔镜检查 胆道镜检查 Choledocholithiasis Primary suture of common bile duct Laparoscopy Choledochoscopy
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