LCBDE并一期缝合治疗胆总管结石的临床研究  

LCBDE and primary suture in the treatment of choledocholithiasis

作　　者：王海刚[1] 黎辉[1] 柯利[1] 张首用[1] 宋楠[1] 

机构地区：[1]华北石油管理局总医院普外二科,河北任丘062552

出　　处：《西北国防医学杂志》2017年第3期179-182,共4页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨腹腔镜胆总管切开取石术(LCBDE)并一期缝合治疗胆总管结石的手术方法及临床效果。方法:选取2013-01~2016-01本院肝胆外科手术治疗的胆总管结石患者108例,采用随机分组法分为A组、B组,各54例。A组采用LCBDE并一期缝合治疗,B组采用LCBDE联合T管引流,对比两组手术效果差异。结果:两组的手术时间、术中出血量、腹腔引流时间差异均无统计学意义(P>0.05);A组的胃肠道功能恢复时间、术后住院时间均少于B组,差异均具有统计学意义(P<0.05);术前、术后48h,两组的外周血白细胞(WBC)、C反应蛋白(CRP)、总胆红素(TBIL)差异均无统计学意义(P>0.05);A组的结石残留及并发症发生率为3.70%,低于B组的14.81%(P<0.05)。结论:LCBDE并一期缝合治疗胆总管结石手术效果可靠,术后恢复快,并发症发生率较低。Objective： To explore the clinical effect of laparoscopic common bile duct exploration （LCBDE） and primary suture in the treatment of choledocholithiasis patients. Methods： A total of 108 patients with choledocholithiasis in our hospital department of hepatobiliary surgery operation from January 2013 to January 2016,were randomly divided into group A and group B, 54 cases in each group, group A were treated with laparoscopic choledocholithotomy and primary suture treatment, group B were treated with laparoscopic choledocholithotomy with T tube drainage. The difference of the operation effect between the two groups were compared. Results： The operation time, intraoperative bleeding, abdominal drainage time in two groups were not statistically significant （P 〉0.05）. Gastrointestinal functionrecovery time, postoperative hospitalization time in group A were shorter than those in group B, the differences were statistically significant （P 〈 0.05）. Before operation, 48 h, after surgery,WBC,CRP, TBIL in two groups, the difference was not statistically significant （P 〉0.05） ;residual stones and rate of complications was 3.70% lower than group B 14.81%（P〈 0.05）.Conclusion： LCBDE and primary suture in the treatment of choledocholithiasis were reliable, quick recovery and low complication rate.

关 键 词：胆总管切开取石术 腹腔镜 缝合 胆总管结石 

分 类 号：R657.42[医药卫生—外科学]