摘要
目的:探讨腹腔镜胆总管一期缝合中经胆囊管路径和经胆总管路径取石治疗胆总管结石合并胆囊结石的临床疗效。方法:选取58例诊断为胆总管结石合并胆囊结石的患者,分别经胆囊管入路取石26例和直接切开胆总管取石32例,行腹腔镜联合胆道镜或腹腔镜联合胆道镜、十二指肠镜术中同期一期缝合术。比较两组胆总管直径、手术时间、术中出血量、住院时间、术后第一日腹腔引流量、腹腔引流管拔管时间、术后谷丙转氨酶、术后总胆红素、术后并发症发生率。结果:两组患者对比,胆总管直径差异有统计学意义(P<0.05)。手术时间、术中出血量、住院时间、术后第一日腹腔引流量、腹腔引流管拔管时间、术后谷丙转氨酶、术后总胆红素、并发症发生率对比,差异无统计学意义(P>0.05)。结论:根据胆总管的不同直径,选择合适的取石路径进入胆总管取净结石后行腹腔镜胆总管一期缝合是可行的,值得深入研究。
Objective:To investigate the clinical effect of choledocholithiasis combined with cholecystolithiasis treated by choledocholithiasis and choledocholithiasis via choledocholithiasis and choledocholithiasis via choledocholithiasis in laparoscopic primary choledocholithiasis suture.Methods:58 patients diagnosed with choledocholithiasis combined with cholecystolithiasis were select ed,respectively,26 cases of choledocholithiasis were extracted through cholecystic duct approach and 32 cases of choledocholithiasis were directly cut open.Laparoscopic combined choledochoscopy or laparoscopic combined choledochoscopy and duodenal suture were performed in the same period and first stage.The intraoperative diameter of common bile duct,duration of surgery,intraoperative blood loss,length of hospital stay,drainage volume of abdominal drainage tube on the first day after surgery,extraction time of abdominal drainage tube,postoperative alanine transaminase,postoperative total bilirubin and incidence of postoperative complications were compared between the two groups.Results:Comparing the two groups of patients,the diameter of common bile duct(P<0.05)was statistically significant.The operative time,intraoperative blood loss,hospitalization time,abdominal drainage volume on the first day after surgery,drainage tube extubation time,postoperative alanine transaminase,postoperative total bilirubin,and complication rate were not statistically significant(P>0.05).Conclusion:According to the choicest choledocholithiasis with different diameters,it is feasible and worth further study to select the appropriate choledocholithiasis extraction path and perform laparoscopic one-stage suture of choledocholithiasis.
作者
刘进衡
王妍亭
何晓璐
肖宏
尹思能
LIU Jin-heng;WANG Yan-ting;HE Xiao-lu;XIAO Hong;YIN Si-neng(Department of Hepatobiliary Surgery,Chengdu Second People's Hospital,Chengdu 610011 China)
出处
《中国现代普通外科进展》
CAS
2021年第1期10-14,共5页
Chinese Journal of Current Advances in General Surgery
基金
2017年四川省卫计委科研项目(17PJ119)。
关键词
经胆囊管路径取石
经胆总管路径取石
腹腔镜胆总管一期缝合术
Stones extraction via cystic duct
Stone removal the common bile duct
Laparoscopic primary suture of common bile duct
