胆总管直径≤1cm的患者行腹腔镜胆总管探查一期缝合术中应用J形胆道支架的体会

Application of J biliary stent in the laparoscopic common bile duct exploration and primary suture for patients with diameter of common bile duct ≤ 1cm

目的:探讨在胆总管直径≤1 cm的患者行腹腔镜胆总管探查一期缝合术中应用J形胆道自脱落支架的价值。方法:回顾分析2015年1月至2017年1月收治的11例患者的临床资料,患者胆总管直径均不超过1 cm,行腹腔镜胆囊切除、胆总管探查一期缝合术。结果:手术均顺利完成,无中转开腹。1例患者胆道支架未自行脱落,经内镜取出,余均自行顺利排出。仅1例患者出现少量胆漏,经通畅引流后术后1周拔除引流管。术后随访6~18个月,患者均无胆道狭窄及结石复发。结论:对于胆总管扩张不明显的患者,腹腔镜胆囊切除、胆总管探查取石一期缝合术中置入胆道支架是安全、有效的。

Objective： To explore the application of J biliary stent in the laparoscopic common bile duct exploration and primary suture for patients with diameter of common bile duct ≤ 1 cm. Methods： The clinical data of 11 patients with common bile duct diameter ≤ 1 cm from Jan. 2015 to Jan. 2017 were retrospectively analyzed. Patients underwent laparoscopic cholecystectomy,common bile duct exploration and primary suture. Results： All patients underwent a successful operation without conversion to laparotomy. All biliary stents removed spontaneously except 1 biliary stent was removed by endoscope. Only 1 patient suffered from light bile leakage and underwent unobstructed drainage,the drainage tube was removed one week after the operation. Neither biliary stricture nor calculi recurrence occurred after a follow-up for 6 to 18 months. Conclusions： If the dilatation of common bile duct is not obvious,the application of J biliary stent in laparoscopic cholecystectomy,common bile duct exploration and primary suture is safe and effective.