腹腔镜胆总管探查术在二次胆道探查中的应用

The application of laparoscopic common bile duct exploration in second biliary tract exploration

目的:探讨腹腔镜胆总管探查术在二次胆道探查中的安全性与可行性。方法:选取2016年1月至2017年12月行腹腔镜胆总管探查的60例胆总管结石患者,其中30例患者为二次胆道探查,30例为初次胆道探查。对比分析两组手术时间、术中出血量、术后住院时间、中转开腹率、术后并发症、胆总管结石清除率。结果:两组手术时间、术中出血量、术后住院时间、中转开腹率、术后并发症发生率、胆总管结石清除率差异无统计学意义(P>0.05)。结论:腹腔镜胆总管二次胆道探查术并未明显增加手术难度及术后恢复时间,是安全、可行的,适宜临床推广。

Objective： To explore the safety and feasibility of laparoscopic common bile duct exploration（ LCBDE） in second biliary tract exploration. Methods： A total 60 patients with choledocholithiasis who underwent LCBDE from Jan. 2016 to Dec. 2017 were selected. The outcomes were compared in 30 patients with second biliary exploration and 30 patients with primary biliary exploration who underwent LCBDE. The operative time,intraoperative blood loss,postoperative hospital stay,rate of conversion to laparotomy,postoperative complications,and choledocholithiasis-free rate were compared between the two groups. Results： There were no statistically significant differences in the operative time,intraoperative blood loss,postoperative hospital stay,rate of conversion to laparotomy,postoperative complications,and choledocholithiasis-free rate between the two groups（ P〉0. 05）. Conclusions： Compared with the primary biliary exploration,second biliary exploration in LCBDE does not obviously increase the difficulty of the operation or the recovery time after the operation,is considered to be safe and feasible,and it is suitable for clinical promotion.