腹腔镜下胆总管探查取石Ⅰ期缝合的可行性分析

目的探讨腹腔镜下胆总管探查取石Ⅰ期缝合的可行性。方法回顾性分析2012年9月至2016年9月术前行磁共振胰胆管造影（MRCP）提示胆总管结石的156例患者，均无手术史，将其分为Ⅰ期缝合组（73例）和T管引流组（83例），记录两组患者的手术时间、术中出血量、术后胃肠道功能恢复时间、术后并发症发生率、出院时间、住院总费用。结果在手术时间、术中出血量、术后胃肠道功能恢复时间、术后并发症发生率上两组差异无统计学意义（P〉0．05），但是主要并发症是术后胆漏，经观察、引流保守治疗后均顺利出院，出院时间、住院总费用上Ⅰ期缝合组要明显低于T管引流组（P〈0．05）。结论对于胆总管结石，腹腔镜下胆总管探查Ⅰ期缝合具有一定的可行性，这一技术值得在临床上尤其是基层医院推广。

Objective To research the feasibility of one-stage suture after laparoscopic commom bile duct exploration. Methods We had a retrospective analysis of September 2012 to September 2016 of preoperative magnetic resonance cholangiopanereatography （MRCP） in 156 patients with common bile duct stones in patients who had no history of operation. All patients were divided into one-stage suture group （ 73 cases ） and T-tube drainage group （83 cases） .Then the operation time, intraoperative blood loss, postoperative gastrointestinal function recovery time, postoperative complication rate, hospital time and total hospitalization expenses of the people were recorded. Results In the operative time, intraoperative blood loss, postoperative gastrointestinal function recovery time and incidence of postoperative complications of two groups had no significant difference （P〉0.05） .But the main complications of postoperative was bile leakage. After observation and drainage, these patients were discharged.Discharge time and total hospitalization expenses on one suture group were significantly lower than that in T-tube drainage group （ P〈0.05 ） . Conclusion One-stage suture after laparoscopic commom bile duct exploration is feasible, and this technology is worth promoting in clinic, especially in basic level hospitals.