腹腔镜下胆总管Ⅰ期缝合治疗胆总管结石临床分析

Laparoscopic lithotomy for choledochlothiasis:primary suture of common bile duct versus T-tube drainage

回顾性分析2019年8—12月苏州大学附属第三医院肝胆胰外科胆总管结石行腹腔镜下胆总管探查术+T形管引流或Ⅰ期缝合患者74例的临床资料,其中行Ⅰ期缝合者68例,置T形管引流者6例。行Ⅰ期缝合者的手术时间(88.1±29.9)min、术后住院时间(3.9±1.5)d、住院费用(29578±1072)元,短于T形管引流者的手术时间(144.2±30.7)min、术后住院时间(7.2±3.8)d及低于其住院费用(37468±2844)元(均P<0.05);两者术后并发症发生率差异无统计学意义(P>0.05)。提示腹腔镜下胆管Ⅰ期缝合的治疗效果优于T形管引流,但由于两者具有不同的适应指征,故应根据患者的具体情况选择。

From August 2019 to December 2019,74 patients with choledocholithiasis underwent laparoscopic lithotomy,including 68 cases with primary suture of common bile duct and 6 cases with T-tube drainage.The operation time,postoperative length of hospital stay,hospitalization cost and complications of the two groups were compared.The operation time and length of postoperative hospital stay in primary suture were shorter than those in T-tube drainage group[(88.1±29.9)min vs.(144.2±30.7)min;(3.9±1.5)d vs.(7.2±3.8)d,both P<0.05];the hospitalization cost was lower[(29578±1072)Yuan vs.(37468±2844)Yuan,P<0.05].There was no significant difference in the incidence of postoperative complications between two groups(P>0.05).The primary suture seems to be superior to T-tube drainage in laparoscopic lithotomy,however,two methods have different indications and should be selected according to the individual conditions of patients.