摘要
目的探讨腹腔镜胆总管切开取石术中一期缝合的适应证、技术及治疗效果。方法与术后常规留置T管的患者进行比较，分析腹腔镜联合胆道镜下胆总管切开取石术中一期缝合患者的治疗效果。将78例患者分为2组，比较两者的手术时间，术后住院时间及手术并发症的发生率。结果一期缝合组（38例）患者术后发生2例早期胆漏，留置T管组（40例）患者术后发生3例胆漏；2组未发生胆道残石、胆道狭窄等并发症。两组患者的手术时间、手术并发症发生率差异无统计学意义（P〉0．05）；一期缝合组的术后住院时间、术后恢复工作时间均明显短于留置T管组，两组差异有统计学意义（P〈0．05）。结论在严格掌握适应证的情况下，腹腔镜胆总管切开取石术中一期缝合在技术上可行，疗效安全可靠。
Objective To explore the indication, technology and clinical significance of laparoscopic choledocholithotomy and primary suture in treatment of choledocholithiasis. Methods 78 patients with choledocholithiasis were divided into two groups receiving respectively laparoscopic choledocholithotomy and T-tube drainage treatment, and laparoscopic choledocholithotomy and primary suture after common bile duct exploration. The time of operation, postoperative hospital stay and complications were analyzed and compared. Results Bile leakage occurred in 2 cases in the primary suture group and 3 cases in the T-tube drainage group; No residual stones or biliary stricture was found in either groups. The time of operation, postoperative complications were not statistically different （P 〉 0. 05 ）. The difference in postoperative hospital stay and GI function recovery time between the two groups was statistically sigllificant （P 〈 0. 05 ）. Conclusion In well selected cases, the primary suture of common bile duct after laparoscopic choledocholithotomy is feasible and safe.
作者
张晓君
董梦醒
张军
姜新春
张昕辉
Zhang Xiaojun Dong Mengxing Zhang Jun Jiang Xinchun Zhang Xinhui.(Department of Hepatie-Biliary-Pancreatic-Splenic Surgery, Xuzhou Central Hospital, Xuzhou 221009, China)
出处
《中华普通外科杂志》
CSCD
北大核心
2017年第4期314-316,共3页
Chinese Journal of General Surgery
