单向倒刺线在腹腔镜胆道探查胆总管一期缝合术中的对照研究

A comparative study on primary closure of common bile duct using barbed suture after laparoscopic exploration of common bile duct stones

目的探讨单向倒刺缝线在腹腔镜下胆道探查胆总管一期缝合术中应用的安全性及有效性。方法回顾性分析该科室2013年1月至2015年8月109例患者,其中使用免打结倒刺线与普通缝线行腹腔镜胆总管一期缝合术,比较患者手术时间、胆道缝合时间、并发症及术后恢复情况。结果传统缝线68例,单向倒刺缝线41例。所有患者手术均成功,普通缝线组1例出现手术并发症,为术后有少量胆漏,经腹腔引流管充分引流后治愈。倒刺线组无并发症。两组患者术后胆道并发症发生率(P=0.603)、术中出血量(P=0.069),术后住院时间(P=0.083),差异均无统计学意义;胆管切口缝合时间(P=0.015);手术时间(P=0.023),倒刺线组均低于传统缝线组,两组差异有统计学意义。结论单向倒刺缝线用于腹腔镜胆总管一期缝合术是可行的,可以降低腹腔镜下缝合难度,缩短缝合及手术时间,缩短学习曲线,值得推广。

Objective To explore the effectivity and feasibility of uindirectional barbed suture tor primary closure of common bile duct on Laparoscopic Exploration of Common Bile Duct Stones. Methods From January 2013 to August 2015,109 cases of pri- mary closure of common bile duct after Laparoscopic Exploration of Common Bile Duct Stones were performed in this hospital. The characteristics of these cases were retrospectively comparatively analyzed. Results Conventional braided Sutures in 68 cases（group A） ,barbed Suture Devices in 41 cases（group B）. There was no difference in postoperative hospital stay, intraoperative blood loss and complication rate between the two groups. Differences in bile duct incision suture time and operative time between the two groups were signi{icantly different. Conclusion The application of uindirectional barbed suture for primary closure of common bile duct using barbed suture after Laparoscopic Exploration is a safe and effective way after treatment of choledocholithiasis. This method cuold reduce the difficulty of operation,and shorten the operation time and the learning curve.