摘要
目的观察腹腔镜胆总管切开取石胆总管一期缝合的治疗效果。方法收集本院于2014年8月~2016年8月收治的50例胆总管结石患者。随机分为对照组和实验组,50例患者均采取腹腔镜下胆总管切开取石,对照组置入T管引流,实验组进行胆总管一期缝合,记录患者的手术时间、出血量、并发症及术后住院时间等情况,分析两组的临床疗效。结果 50例患者均在腹腔镜下顺利完成手术。比较两组的手术时间及术中出血量,差异无统计学意义(P>0.05)。对照组术后住院天数平均(9.28±1.90)d,实验组平均(6.04±1.06)d,两组比较差异有统计学意义(t=55.24,P<0.05)。对照组8例患者出现并发症,包括4例胆瘘和4例T管引流不畅,实验组并发症共2例,低于对照组,2例均为胆瘘,两组比较差异有统计学意义(χ~2=4.50,P<0.05)。均于术后随访半年到一年,行B超或EPCR检查,未发现胆总管结石残留。结论腹腔镜胆总管切开取石胆总管一期缝合术在胆总管结石治疗中的疗效显著,且安全可行,值得临床推广。
Objective To observe the curative effect of Primary suture of common bile duct in laparoscopic common bile duct exploration. Methods 50 cases of common bile duct stones cured in our hospital from Auguest 2014 to Auguest 2016 were selected and randomly divided into control group and experimental group.All the patients were treated with laparoscopic common bile duct stone extraction.Patients in control group were with T tube drainage,and patients in experimental group were treated with primary suture of common bile duct.Operation time,blood loss,complications and postoperative hospital stay were recorded.Clinical curative effect of the two groups were analyzed. Results 50 patients were successfully operated under laparoscopy.There was no significant difference in operation time and blood loss between the two groups （P 〉 0.05）.The average length of stay in the control group was（9.28 ± 1.90）days,and the average of the experimental group was（6.04 ± 1.06）days,the difference was significant（i=55.24,P 〈 0.05）.There were 8 patients with complications in control group,including 4 cases of biliary fistula and 4 cases of poor drainage of T tube.There were 2 cases of complications in experimental group.Both of the 2 cases were biliary fistula.It was less than that of control group, and the difference was significant（χ^2=4.50, P 〈 0.05）. All patients were foUowed up for six months to one year.Using B uhrasonography or EPCR examination,no common bile duct stones were found. Conclusion Primary suture of common bile duct in laparoscopic common bile duct exploration has significant curative effect in treatment of of common bile duct stones.It is safe and feasible,worthy of clinical promotion.
出处
《中国医药科学》
2017年第3期172-174,190,共4页
China Medicine And Pharmacy
关键词
腹腔镜
腹腔镜胆总管切开取石
胆总管结石
一期缝合
Laparoscope
Laparoscopic common bile duct stone
Common bile duct stone
Primary suture
