不同缝合方式在腹腔镜胆总管探查术一期缝合中的应用  

Application of different suture methods in laparoscopic common bile duct exploration

作　　者：严栋梁[1] 朱斌[1] 陈杰[1] 臧宏[1] 邵伟斌[1] YAN Dong-liang ZHU Bin CHEN Jie et al(Department of hepatobiliary surgery, Nantong First People＇ s Hospital,Nantong 226001, China)

机构地区：[1]南通市第一人民医院肝胆外科,南通226001

出　　处：《肝胆外科杂志》2016年第6期425-428,共4页Journal of Hepatobiliary Surgery

基　　金：南通市科技局2014年社会发展指导项目资助(HS149021);南通市科技局2015年度市级民生示范推广项目资助

摘　　要：目的比较不同缝合方式在腹腔镜胆总管探查术一期缝合中应用的临床疗效。方法我院2008年7月～2014年6月外科收治的胆囊结石合并胆总管结石患者105例。均实施腹腔镜胆囊切除＋胆总管探查＋胆总管一期缝合术，分为两组，可吸收线连续锁扣缝合组51例，Quill免打结缝合线组54例。结果两组患者在术后胃肠功能恢复时间、术后住院时间比较差异有统计学意义（P〈0．05），手术中出血量、住院总费用、术后并发症发生率两组比较差异无统计学意义（P〉0．05）。两组患者均随访6—24个月，随访期内均未发现胆管狭窄及胆管炎？残余结石等情况。结论在具备丰富的腹腔镜操作技术的基础上，胆总管一期缝合是安全的，疗效确切。使用Quill免打结缝合线具有手术时间短，操作更加简便等优点。Objective To compare different suture used in laparoscopic exploration of common bile duct in one stage suture clinical curative effect. Methods In our hospital from 2008 July 2014 in June admitted in the Department of cholecystolithiasis com- bined with choledocholithiasis （ n = 105 ）. Were performed laparoscopic cholecysteetomy and exploration of common bile duct and com- mon bile duct resection one stage suture, divided into two groups, the absorbable suture line in the continuous locking group （51 eases）, quill free knotted suture group 54 cases. Results Two groups of patients in the postoperative gastrointestinal function recovery time, postoperative hospitalization time difference was statistically significant （ P 〈 0. 05 ）, amount of bleeding during operation, total cost of hospitalization, postoperative complications rate difference between the two groups was not statistically significant （P 〉 0. 05 ）. Two groups of patients were followed up for 6 - 24 months, during the follow-up period were not found bile duct stricture and cholangitis, residual stones. Conclusion With abundant laparoscopic operation technology based and primary closure of the common bile duct is safe and effective. The use of Quill suture free suture with a short operation time, the operation is more convenient and so on.

关 键 词：腹腔镜 胆总管一期缝合 缝合方式 胆总管结石 

分 类 号：R657.9[医药卫生—外科学]