腹腔镜下胆总管切开探查Ⅰ期缝合术的临床应用效果研究

Clinical application of laparoscopic common bile duct exploration and primary suture

目的:分析腹腔镜下胆总管切开探查Ⅰ期缝合术的临床应用效果。方法:2016年3月-2019年3月收治行腹腔镜胆总管切开探查的患者143例,其中采用Ⅰ期缝合患者70例,纳入观察组;另外留置T管患者73例,纳入对照组。观察不同方案应用效果。结果:观察组腹腔引流管拔除时间、肛门排气时间、住院时间及进食时间均低于对照组,差异有统计学意义(P<0.05);观察组术后1 h、12 h、24 h及32 h疼痛评分均低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜胆总管切开探查联合Ⅰ期缝合治疗方案安全有效,与留置T管方式对比,更有助于缩短患者术后恢复时间,优化生活质量。

Objective:To analyze the clinical effect of primary suture of laparoscopic choledochotomy and exploration.Methods:From March 2016 to March 2019,143 cases of patients who underwent laparoscopic choledochectomy and exploration were enrolled,among them,70 cases of patients with primary suture were included in observation group.Another 73 cases of patients with indwelling T tube were included in the control group.The application effect of different groups was observed.Results:The extraction time of abdominal drainage tube,the anal exhaust time,the lengths of hospital stay and eating time in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The pain scores of the observation group at 1 h,12 h,24 h and 32 h after surgery were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The primary suture of laparoscopic choledochotomy and exploration is safe and effective,compared with indwelling T tube,it is helpful to shorten postoperative recovery time and optimize quality of life.