腹腔镜下胆总管一期缝合在胆总管切开取石术中的临床效果及手术安全性分析

Clinical Effect and Safety Analysis of Laparoscopic Primary Suture of Common Bile Duct in Choledocholithotomy

目的:探究腹腔镜下行胆总管一期缝合在胆总管切开取石术中的临床效果及手术安全性。方法:选取2016年7月-2019年10月本院收治的90例胆总管结石患者为研究对象,按随机数字表法分为两组,各45例。观察组行腹腔镜下胆总管一期缝合,对照组行腹腔镜下T管引流。对比两组患者临床效果及并发症发生情况。结果:观察组手术时间、伤口疼痛持续时间、肠功能恢复时间、肝功能恢复时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组术后胆漏、胰腺炎、切口感染、结石复发、胆道狭窄等并发症发生率与对照组比较差异无统计学意义(P>0.05)。结论:在严格把握指征及熟练掌握手术操作技巧的基础上,腹腔镜胆总管切开取石术中实施胆总管一期缝合,其临床疗效确切,手术安全可靠。

Objective:To explore the clinical effect and safety of laparoscopic common bile duct primary suture in choledocholithotomy.Method:A total of 90 patients with choledocholithiasis admitted to our hospital from July 2016 to October 2019 were selected as research objects and divided into two groups according to the random number table method.Each of 45 patients.The observation group underwent laparoscopic primary suture of common bile duct,and the control group underwent laparoscopic T-tube drainage.The clinical effect indexes and complications were compared between the two groups.Result:The clinical indicators of the observation group were all shorter than the control group in operation time,duration of wound pain,recovery time of intestinal function,recovery time of liver function and length of hospital stay (P<0.05).There were no statistically significant differences in the incidence of postoperative biliary leakage,pancreatitis,incision infection,stone recurrence and biliary stricture complications between the observation group and the control group (P>0.05).Conclusion:On the basis of grasping the indications strictly and mastering the operation skills,the laparoscopic choledocholithotomy with one-stage suture of common bile duct is effective and safe.