腹腔镜胆总管探查胆管一期缝合术(附35例报告)  

Exploration and primary suture of common bile duct in laparoscopic procedure (a report of 35 cases)

作　　者：陈斌[1] 秦仁义[1] 胡明彦[2] 石正军[2] 

机构地区：[1]华中科技大学同济医学院同济医院普外科,湖北武汉430030 [2]江汉石油管理局中心医院内镜外科,湖北潜江433121

出　　处：《中国普通外科杂志》2002年第10期581-583,共3页China Journal of General Surgery

摘　　要：目的　探讨腹腔镜胆囊切除术 (LC)及胆总管探查、一期缝合胆总管的方法和效果。方法　LC后立即探查 3 5例有病变的胆总管 ,并进行胆道镜检查和取石 ,在取尽结石、确定胆总管下端无狭窄情况下 ,用可吸收线一期缝合胆总管。结果　 3 2例胆总管结石取尽 ,3例探查阴性 ,3 5例全部行一期缝合胆总管 ,术后出现胆漏 2例 ,经保守治疗治愈。随访 2 9例 ,时间 3～ 2 4个月 ,无结石残留和胆管狭窄发生。结论　如病例选择恰当 ,腹腔镜下胆总管一期缝合是安全和有效的。Objective To determine the methods and effects of common bile duct(CBD) exploration and primary suture by laparoscopic procedure after laparoscopic cholecystectomy (LC) . Methods After LC, 35 patients' CBD were explored.After hte CBD stone was removed by choledochofiberscopy completely and CBD stenosis was excluded, the CBD was sutured primarily. Results 32 cases of CBD gallstone were removed ,and 3 exploration were negative.All the 35 CBD were sutured primarily . Two patients occurred bile leakage 1～3 day after the operation ,which were cured by conservative therapy.29 patients were followed-up for 3～24 months,no residual stone or bile duct stricture was found. Conclusions Primary suture CBD is safe and effective in laparoscopic CBD exploration,if the patient selected correctly.

关 键 词：腹腔镜胆总管探查 胆管一期缝合术 胆总管结石 T管引流 

分 类 号：R657.42[医药卫生—外科学]