腹腔镜胆总管探查一期缝合术2326例报告

Primary Closure of Bile Duct Incision in Laparoscopic Bile Duct Exploration: A Report of 2326 Cases

目的:总结运用腹腔镜胆总管探查一期缝合术的治疗经验。方法:回顾性分析1992年6月至2017年6月,成都市第二人民医院运用腹腔镜胆总管探查一期缝合术对2326例病人进行治疗的经验及效果。结果:一期缝合的2326例病人中有2148例(92.3%)腹腔镜手术获成功,中转开腹获成功15例(0.6%)。术后胆汁漏94例(4.0%),术后残石29例(1.2%),1例胰腺癌术后15 d死亡(0.1%),术后有其他并发症39例(1.7%),总并发症发生率为7.0% (163/2326)。结论:从本研究对本医院有限病例进行初步研究发现,只要选择合适的病例,腹腔镜胆总管探查一期缝合术是可行、有效和安全的。

Objective: To summarize the experience on laparoscopic choledochotomy with primary suture. Methods: From June 1992 to June 2017 in the Second People,s Hospital of Chengdu, 2326 patients were received the primary closure of duct incision in laparoscopic common bile duct exploration. Results: It had obtained successful in 2148 (92.3%) out of 2326 patients, fifteen cases (0.6%) were shifted to open common bile duct exploration. Bile leakage occurred in 94 cases (4.0%). Residual stones were in 29 cases (1.2%). One patient (0.1%) of pancreatic carcinoma died in post-operation 15 days. Thirty-nine cases (1.7%) were other complications. Total postoperative complication formation rate is 7.0% (163/2326). Conclusion: From preliminary results of limited cases in this study in our hospital, if patients are suitable, laparoscopic choledochotomy with primary closure was a feasible, safe and effective method.