腹腔镜下倒刺缝线与可吸收缝线缝合胆总管切口的效果比较研究

Comparison of unidirectional barbed suture and traditional suture for closing choledoch incision

目的评价免打结倒刺缝线运用于腹腔镜下胆总管切开取石后Ⅰ期缝合的临床效果。方法选取2015年1月-2015年10月到该院就诊的胆囊结石伴有胆总管结石并行腹腔镜下胆囊切除、胆总管切开、探查取石和Ⅰ期缝合术的患者共计66例,并随机分为两组。实验组30例在术中采用倒刺缝线连续缝合胆总管切口。对照组36例在术中采用可吸收缝线连续扣锁缝合。术后比较两种缝合方式在手术时间、术中胆漏发生率及术后胆漏发生率的差异。结果两组患者共计66人均成功于腹腔镜下完成手术,无中转开腹,其中实验组在缝合时间、术中胆漏发生率上与对照组相比,差异有统计学意义(P<0.05),实验组在缝合时间上少于对照组,在术中胆漏的发生率低于对照组,但在术后的胆漏发生情况上,实验组与对照组的差异无统计学意义(P>0.05)。结论倒刺缝线在腹腔镜下连续缝合胆总管切口与传统可吸收缝线相比,具有手术时间短,术中及术后胆漏发生率低等特点,值得临床推广。

Objective To evaluate the efficacy and safety of continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision. Methods From January 2015 to October 2015, 66 patients with gall bladder calculi combined with common bile duct stones who received laparoscopic gallbladder excision, common bile duct exploration, laparoscopy choledochotomy, suture choledoch immediately were randomly divided into two groups, experi- mental group using QuillTM SRS self-retaining suture for closing eholedoch incision and control group using tradi- tional absorbable suture for closing choledoeh incision. Then observe the operation time, the risk of bile leakage oc- curred in the operation and the risk of bile leakage after operation. Results All patients successfully completed in laparoscopic surgery without laparotomy. Operation time, the risk of bile leakage occurred during operation in exper- imental group has statistically significant difference compared with control group （P 〈 0.05）. The operation time and incidence of intraoperative bile leakage of the experimental group was less and lower than control group, while the risk of bile leakage after operation show no statistically difference （P 〉 0.05）. Conclusion Compared with interrupted suture by normal sutures, continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision has the characteristics of shorter operation time and lower incidence of intraoperative and postoperative bile leakage. It is worthy of promoting.