双镜联合胆总管探查胆道一期缝合的临床研究  

Clinical analysis of primary suture of bile duct in laparoscopic combined with choledochoscopic choledochus exploration

作　　者：杨海峰 邹兵 潘光明 YANG Haifeng;ZOU Bing;PAN Guangming(Department of Hepatobiliary Surgery,the Second Affiliated Hospital Guizhou Medical University,Qiandongnan,Guizhou 556000,China)

机构地区：[1]贵阳医科大学第二附属医院肝胆外科,黔东南556000

出　　处：《重庆医学》2019年第A01期111-113,共3页Chongqing medicine

摘　　要：目的探讨腹腔镜胆道探查一期胆管缝合术的可行性。方法选择2013年1月至2017年10月该院肝胆外科收治的行腹腔镜胆道探查患者137例,根据患者术前检查及术中胆道镜检查结果行一期胆管缝合(86例)或T管引流术(51例)。观察患者手术时间、术后肠功能恢复、术后恢复正常活动时间、住院时间、住院费用等,并对患者术后并发症等情况进行分析。结果相比于T管引流术,一期胆道缝合可显著缩短患者术后恢复正常活动时间和住院时间,降低住院费用,减少术后胆漏发生率,差异均有统计学意义(P<0.05);而手术时间、术后腹腔感染和结石残留比较,差异均无统计学意义(P>0.05)。结论腹腔镜胆道探查术后胆管一期缝合治疗胆总管结石是安全、可行的,且避免了放置T管引流所引起的一些弊端,体现了微创外科及快速康复外科的优越性。Objective To explore the feasibility of laparoscopic primary bile duct suture. Methods Selected to the patients of perform laparoscopic biliary tract exploration in our hospital's Department of Hepatobiliary Surgery,According to the results of preoperative examination and intraoperative choledochoscopy,primary bile duct suture(86 cases) or T-tube drainage(51 cases).The time of operation,the recovery of intestinal function,the time of recovery of normal activity,the days of hospitalization and the cost of hospitalization were observed,and the postoperative complications were analyzed. Results Compared with T-tube drainage,primary bile duct suture can significantly shorten the time of recovery of normal activity and hospital stay,and reduce the cost of hospitalization.The incidence of postoperative biliary leakage was reduced( P <0.05),but there was no significant difference in operative time,postoperative abdominal infection and residual stone( P >0.05). Conclusion It is safe and feasible to treat choledocholithiasis patients with primary suture of bile duct after laparoscopic exploration of bile duct,and some disadvantages caused by T-tube drainage are avoided,which shows the superiority of minimally invasive surgery and rapid rehabilitation surgery.

关 键 词：腹腔镜胆道探查 一期缝合 T管引流术 

分 类 号：R657.42[医药卫生—外科学]