腹腔镜下连续缝合法在治疗胆总管结石中的手术效果及安全性分析

The research on Continuous versus interrupted suture technique in effectiveness and safety of laparoscopic common bile duct exploration for patients with CBD stone

目的对胆总管结石患者行腹腔镜胆总管探查术(Laparoscopic Common Bile Duct Exploration,LCBDE)治疗的病例进行回顾性分析,比较LCBDE术中应用连续缝合法与间断缝合法缝合胆总管的手术效果与安全性。方法选取2012年1月~2018年1月我科收治的胆总管结石患者56例,分为2组,其中行LCBDE术应用连续缝合法缝合胆总管为连续缝合组(n=32),行LCBDE术应用间断缝合法缝合胆总管为间断缝合组(n=24);两组手术时间、术中出血量、术后胆漏、胆总管狭窄、住院天数等方面进行比较。结果与间断缝合组比较,连续缝合法使手术时间缩短,差异有统计学意义(P<0.05)。术后胆漏、黄疸、胆总管狭窄等手术并发症无显著性差异(P>0.05)。术中出血量、术后住院天数、引流管拔除天数等无显著性差异(P>0.05)。结论在LCBDE术中应用连续缝合法或间断缝合法缝合胆总管,安全性无显著性差异,连续缝合法可以缩短手术时间,提高手术效率,值得推广。

Objective This retrospective clinical study was conducted to compare the continuous and interrupted suture technique on Continuous versus interrupted suture technique in effectiveness and safety. laparoscopic common bile duct exploration for patients with gallbladder and CBD stone. Method 56 patients subjected to LCBDE were divided into two group according to the suture technique used： interrupted or continuous. We analyzed The operating time, intraoperative bleeding, postoperative complications, postoperative hospital stay etc. Results There were no statistically significant in the open conversion rate, blood loss, hospital stay, bile leakage, biliary strictures. These suggest that the effectiveness and safety of Continuous suture for laparoscopic common bile duct exploration. The patients with interrupted technique had longer operative times spent in the operation. There was 1.88 ± 0.20 hour spent in the continuous group and 2.47 ± 0.44 hour spent in the interrupted group, presenting significant difference （ P 〈 0. 05 ）. Conclusion The continuous suture technique shows a shorter time spent in the operation than interrupted technique.