电视腹腔镜胆总管切开探查后胆总管Ⅰ期缝合术  

Primary suture after laparoscopic common bile duct exploration without T tube drainage: report of 20 cases

作　　者：王存川[1] 徐以浩[1] 陈均[1] 王志伟 

机构地区：[1]暨南大学医学院第一附属医院腹腔镜外科,广州510630 [2]河南省邓州市公疗医院外科

出　　处：《中华普通外科杂志》2000年第8期478-479,共2页Chinese Journal of General Surgery

摘　　要：目的　探讨腹腔镜胆总管探查手术后胆总管切口的处理方法 ,免除患者术后带T型管的痛苦。方法　选择腹腔镜胆总管切开探查术的 2 0例患者在取出结石或蛔虫后Ⅰ期缝合胆总管 ,其中 2层缝合 17例 ,1层缝合 3例。结果　 2 0例均成功完成手术 ,手术时间 45～ 170min ,平均 12 6min ,术后平均 6d(3～ 10d)出院 ,18例患者取出 0 6～ 2 9cm结石 1～ 6粒 ,2例患者分别取出死蛔虫 1、2条。 1层缝合 1例出现轻度胆汁渗漏。结论　腹腔镜胆总管切开探查后选择性行胆管Ⅰ期缝合是安全的 ,术后患者出院早、痛苦小 ,恢复快 ;二层缝合可减少胆汁渗漏机会。Objective[WT5”BZ] To study the rationale of primary suture of the incision on common bile duct (CBD)without the use of T-tube after laparoscopic CBD exploration(LCBDE).[WT5”HZ] Methods[WT5”BZ] The incision on CBD of 20 cases were primarily sutured after removing stones or ascarid by laparoscopic procedure from Jun.1996 to Sep.1999. 17 cases had a two-layer-suture for CBD incision, and 3 cases had a one-layer.[WT5”HZ] Results[WT5”BZ] All cases were operated on successfully. The operation time averaged 126 (45～170) min. The average length of postoperative hospital stay was 6 (3～10) days. 1～6 calculus (0 6～2 9*!cm) in 18 cases and 1～2 ascarid in two cases were taken out. There were no mortality nor severe complications. One case with one-layer-suture had slight biliary fistula and was cured conservatively.[WT5”HZ] Conclusions[WT5”BZ] It was found that primary suture of CBD after LCBDE is safe[CM(43] withadvantage of short postoperative stay, less pain and rapid recovery, and the two layer′s suture of CBD can further decrease the risk of postoperative biliary fistula. [WT5”HZ]

关 键 词：胆管疾病 电视腹腔镜 Ⅰ期缝合术 

分 类 号：R657.4[医药卫生—外科学]