肝外胆管结石患者腹腔镜下胆总管切开探查术后一期缝合治疗对并发症的影响

Effect of Primary Suture after Laparoscopic Common Bile Duct Exploration onComplications in Patients with Extrahepatic Bile Duct Stones

目的探讨腹腔镜下胆总管切开探查术后一期缝合治疗肝外胆管结石患者的效果及对其并发症的影响。方法选取2018年6月至2020年6月无锡市第二人民医院收治的60例肝外胆管结石患者作为研究对象,将其采用电脑单双号抽签的方式分成对照组和观察组,每组30例,两组患者均采用腹腔镜下胆总管切开探查术治疗,抽取单号的患者纳入对照组,术后进行T管引流处理,抽取双号的患者纳入观察组,术后进行一期缝合处理,对比两组患者手术相关指标、并发症发生率及术后生活质量的评分情况。结果与对照组比较,观察组的手术耗费时间更短、术中失血量更少、术后肛门排气时间更早及住院耗费时间更短、胆汁引流量更少(P<0.05);观察组6.67%的并发症发生率显著较对照组的33.33%少(P<0.05);观察组术后生活质量评分显著优于对照组(P<0.05)。结论针对肝外胆管结石患者,腹腔镜下胆总管切开探查术后一期缝合可取得理想的治疗效果,并发症少,有利于患者后期恢复,促使其尽快达到出院指标,使得患者的生活质量全面提升。

Objective To investigate the effect of primary suture after laparoscopic common bile duct exploration in the treatment of extrahepatic bile duct stones and its complications.Methods A total 60 patients with extrahepatic bile duct stones who were admitted to Wuxi Second People’s Hospital from June 2018 to June 2020 were selected as the research objects,and they were divided into two groups by means of single and double numbers,30 cases in each group.Both groups were under laparoscopy common bile duct incision and exploratory treatment,patients with single number were selected into the control group,T-tube drainage treatment after operation,patients with double number were included in the observation group,and one-stage suture treatment was performed after the operation.The relevant indicators during hospitalization complication rate and postoperative quality of life score of the two groups were compared.Results Compared with the control group,the observation group had shorter operation time,less blood loss,earlier anal exhaust time,shorter drainage tube retention time and hospitalization time,and less bile drainage volume(P<0.05);the complication rate of 6.67%in the observation group was significantly less than 33.33%in the control group(P<0.05);the postoperative quality of life score of the observation group was significantly better than that of the control group(P<0.05).Conclusion For patients with extrahepatic bile duct stones,laparoscopic common bile duct exploration after primary suture can achieve ideal therapeutic effect,fewer complications,which is conducive to the late recovery of patients,promote them to reach the discharge index as soon as possible,so that the quality of life of patients can be comprehensively improved.