经脐入路腹腔镜经胆囊管行胆总管探查一期缝合术的临床观察  

Transumbilical laparoscopic transcystic common bile duct exploration and primary suture

作　　者：郁林海[1,2] 顾春飞[1,2] 冯林松[1,2] 褚永悦[1,2] 朱海峰[1,2] 方胜利[1,2] 

机构地区：[1]上海中医药大学附属曙光医院松江分院 [2]松江区方塔中医院普外科,上海201600

出　　处：《外科理论与实践》2015年第1期43-47,共5页Journal of Surgery Concepts & Practice

摘　　要：目的 :探讨经脐入路腹腔镜经胆囊管行胆总管探查一期缝合术的可行性及临床效果。方法 :回顾性分析2009年11月至2013年2月90例具有胆总管探查指征的病人实施经脐入路腹腔镜经胆囊管行胆总管切开取石治疗的临床资料,术后48例行胆总管一期缝合(A组),42例行T管引流(B组)。记录各种临床指标及围手术期并发症发生情况。结果:A组手术时间、术后住院时间、住院费用和恢复时间显著低于B组,差异有统计学意义(P<0.001)。两组腹腔引流管放置时间比较,差异无统计学意义(P>0.05)。A组术后并发症发生率(14.6%)低于B组(23.8%),差异有统计学意义(P<0.01)。结论:经脐入路腹腔镜经胆囊管行胆总管探查一期缝合术治疗胆总管结石优于T管引流,具有微创、术后恢复快、并发症少等优点,可以作为治疗胆总管结石优先考虑的手术方式。Objective To discuss the feasibility and results of transumbilical laparoscopic transcystic common bile duct exploration and primary suture. Methods The data of 90 patients with transumbilical laparoscopic transcystic common bile duct exploration from November 2009 to February 2013 were analyzed retrospectively. Forty-eight cases had primary suture of common bile duct（A group） and 42 cases T tube drainage（B group）. Clinical parameters and perioperative complications were provided. Results The parameters of the patients in A group including operation time, postoperative hospital stay, hospital costs and time to return normal were significantly lower than those in the B group（P0.001）. The duration of abdominal drainage of the two groups were not statistically significant（P0.05）. The difference of surgical complication between A group（14.6%） and B group（23.8%） was statistically significant（P0.01）. Conclusions The transumbilical laparoscopic transcystic common bile duct exploration and primary suture for choledocholithiasis was better than Ttube drainage and could be priority for treatment of common bile duct stones with the advantage of minimally invasive, fast postoperative recovery and less surgical complication.

关 键 词：经脐入路内镜手术 腹腔镜胆总管探查 一期缝合 T管引流 

分 类 号：R657.4[医药卫生—外科学]