摘要
目的:总结胆总管结石施行胆总管探查一期缝合术的临床经验,并探讨其一些细节问题。方法:通过对291例胆总管探查(免T管一期缝合)手术及术后随访进行对比观察。结果:291例患者全部完成手术,术后腹腔胆漏11例,胆管造影发现27例胆总管一期缝合处胆管狭窄,患者无自觉症状,酶学指标无异常,未予处理。术后乳头梗阻性黄疸3例,经内镜治愈。术后远期结石再发17例。其他术后并发症经非手术综合治疗治愈。其并发症发病率低于常规T管引流。结论:只要病例选择合适,腹腔镜胆总管探查一期缝合胆总管是安全、可行、有效的。其指证掌握、围手术期治疗、手术操作、缝线选择等小细节上,仍有探讨价值。
Objective：To summarize the clinical experience and the details of the primary suture of the common bile duct of in the implementation of the common bile duct stone.Method：Compared the surgery and postoperative follow-up observation of the 291 cases of common bile duct exploration surgery （Free T-tube a suture）.Result：291 patients completed the surgery, 11 cases intraperitoneal leakage of bile after operation, cholangiography found 27 cases of the suture common bile duct stenosis, patients with no symptoms, enzymatic indicators normal.3 cases with nipple obstructive jaundice after operation, endoscopic cure.17 cases with long-term stone recurrence.Other postoperative complications cured with non- surgical treatment. The incidence of complications was lower than the conventional T-tube drainage.Conclusion：As long as appropriate patient selection, the primary suture of common bile duct in laparoscopic common bile duct exploration is safe, feasible and effective.Some details still need to discuss, the perioperative treatment, surgical procedures, suture line choice.
出处
《中国医学创新》
CAS
2012年第22期87-88,共2页
Medical Innovation of China
关键词
胆总管探查
一期胆道缝合
适应证
Common bile duct exploration
Primary suture of the bile duct
Indication
