腹腔镜胆总管切开取石一期缝合治疗胆总管结石的临床效果  

Clinical efficacy of laparoscopic choledocholithotomy and primary suture in the treatment of patients with choledocholithiasis

作　　者：蒋星星[1] 张昱君 方俐超 曾志峰[1] JIANG Xingxing;ZHANG Yujun;FANG Lichao;ZENG Zhifeng(Department of Hepatobiliary Surgery,the Affiliated Xinyu Hospital of Nanchang University,Jiangxi Province,Xinyu 338025,China)

机构地区：[1]南昌大学附属新余医院肝胆外科,江西新余338025

出　　处：《中国当代医药》2023年第26期89-92,共4页China Modern Medicine

基　　金：江西省新余市科技计划项目(20203090845)。

摘　　要：目的探讨腹腔镜胆总管切开取石一期缝合治疗胆总管结石的临床疗效及应用价值。方法选取2019年1月至2021年12月就诊于南昌大学附属新余医院的86例胆总管结石患者作为研究对象,采用抽签法将其分为观察组(42例)和对照组(44例)。观察组采用腹腔镜胆总管切开取石一期缝合术,对照组采用腹腔镜胆总管切开取石T管引流术。比较两组住院总费用、术后住院时间、手术时间、术后肛门排气时间、结石残留及术后并发症。结果观察组住院总费用少于对照组,术后住院时间、术后肛门排气时间短于对照组,差异有统计学意义(P<0.05)。观察组术后镇痛率低于对照组,差异有统计学意义(P<0.05)。两组患者的手术时间、术中出血量、结石残留、切口感染、术后胆漏及胆道感染发生率比较,差异无统计学意义(P>0.05)。结论合理把握适应证的前提下,腹腔镜胆总管切开取石一期缝合治疗胆总管结石临床疗效确切,较留置T管更符合微创外科理念。Objective To investigate the clinical efficacy and application value of laparoscopic choledocholithotomy and primary suture in the treatment of patients with choledocholithiasis.Methods A total of 86 patients with choledocholithiasis admitted to the Affiliated Xinyu Hospital of Nanchang University from January 2019 to December 2021 were selected as the research objects.They were divided into observation group(42 cases)and control group(44 cases)by simple random sampling method.The patients in the observation group were treated with laparoscopic choledocholithotomy and primary suture,and the control group were treated with laparoscopic choledocholithotomy and T-tube drainage.The total cost of hospitalization,postoperative hospital stay,operation time,postoperative anal exhaust time,residual stones and postoperative complications were compared between two groups.Results The total cost of hospitalization in observation group was less than that in control group,and the postoperative hospitalization time and postoperative anal exhaust time were shorter than those in the control group,the differences were statistically significant(P<0.05).The postoperative analgesia rate in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There were no significant differences in the operation time,intraoperative blood loss,residual calculi,wound infection,postoperative bile leakage and biliary infection rate between the two groups.Conclusion In reasonable selected cases,laparoscopic choledocholithotomy and primary suture in the treatment of patients with choledocholithiasis is effective and more consistent with minimally invasive surgery concept compared with T-tube drainage.

关 键 词：胆总管结石 一期缝合 T管引流 临床疗效 

分 类 号：R615[医药卫生—外科学]