腹腔镜下胆总管切开取石术联合胆总管缝合技术研究  

Study on Technology of Laparoscopic Choledocholithotomy Combined with Suture of Common Bile Duct

作　　者：张海林[1] Zhang Hai-lin(Department of General Surgery,Peking University Shougang Hospital,Beijing 100144,China)

机构地区：[1]北京大学首钢医院普外科,北京100144

出　　处：《中国社区医师》2022年第16期30-32,共3页Chinese Community Doctors

摘　　要：目的:胆总管结石患者采用不同缝合方式完成腹腔镜下胆总管切开取石术联合胆总管缝合术治疗后临床效果分析。方法:选取2018年1月-2021年4月北京大学首钢医院收治的60例胆总管结石患者进行治疗研究;随机分为对照组(采用薇乔线间断缝合方法完成腹腔镜下胆总管切开取石术联合胆总管缝合术治疗)和研究组(采用薇乔线连续缝合方法完成腹腔镜下胆总管切开取石术联合胆总管缝合术治疗),各30例。比较两组患者术中出血量、手术总时间、肠道功能恢复时间、胆总管缝合时间、术后住院时间、胆漏发生率。结果:研究组术中出血量少于对照组,差异有统计学意义(P<0.05);两组手术总时间比较,差异无统计学意义(P>0.05);研究组肠道功能恢复时间、胆总管缝合时间及术后住院时间短于对照组,差异均有统计学意义(P<0.05)。两组术后1 d、3 d及7 d胆漏发生率比较,差异无统计学意义(P>0.05)。结论:临床针对胆总管结石患者采用薇乔连续缝合方法完成腹腔镜下胆总管切开取石术联合胆总管缝合术治疗,可将患者术中出血量减少,并缩短肠道功能恢复时间、胆总管缝合时间、术后住院时间,可改善胆总管结石患者手术治疗效果。Objective:To analyze the clinical effect of laparoscopic choledocholithotomy combined with suture of common bile duct with different suture methods in the treatment of patients with choledocholithiasis. Methods: A total of 60 patients with choledocholithiasis admitted to Peking University Shougang Hospital from January 2018 to April 2021 were selected for the treatment study. The patients were randomly divided into the control group(laparoscopic choledocholithotomy combined with suture of common bile duct were performed with Vicryl interrupted suture method) and the study group(laparoscopic choledocholithotomy combined with suture of common bile duct were performed with Vicryl continuous suture method), with 30cases in each group. The amount of intraoperative blood loss, total operation time, intestinal function recovery time, common bile duct suture time, postoperative hospital stay and incidence of bile leakage were compared between the two groups. Results: The intraoperative blood loss in the study group was less than that in the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the total operation time between two groups(P>0.05). The intestinal function recovery time, common bile duct suture time and postoperative hospital stay in the study group were shorter than those in the control group, and the differences were statistically significant(P<0.05). There were no statistically significant differences in the incidence of biliary leakage at postoperative 1 d, 3 d and 7 d between the two groups(P>0.05). Conclusion: In clinical treatment of choledocholithiasis patients, laparoscopic choledocholithotomy combined with suture of common bile duct are performed with Vicryl continuous suture method, which can reduce the amount of intraoperative blood loss, shorten the intestinal function recovery time, common bile duct suture time and postoperative hospital stay, and improve surgical treatment effect of choledocholithiasis patients.

关 键 词：腹腔镜下胆总管切开取石术 胆总管缝合技术 薇乔线缝合 胆总管缝合时间 胆漏发生率 

分 类 号：R657.4[医药卫生—外科学]