不同缝合技术在胆总管结石手术中的应用效果  

Comparison of effect of different suture techniques in surgery for common bile duct stones

作　　者：郭伟[1] 王劲[1] 杨磊[1] Guo Wei;Wang Jin;Yang Lei(Department of Hepatobiliary and Pancreatic Hernia Surgery,Jiaozuo People’s Hospital,Jiaozuo 454002,China)

机构地区：[1]焦作市人民医院肝胆胰疝外科,焦作454002

出　　处：《中国实用医刊》2023年第11期57-60,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较不同缝合技术在胆总管结石行腹腔镜联合胆道镜取石T管引流术中的临床应用效果。方法前瞻性分析。抽取2021年1月至2022年1月于焦作市人民医院拟行腹腔镜联合胆道镜取石T管引流术的99例胆总管结石患者,根据随机数字表法分为A、B、C三组,每组33例。三组患者均行腹腔镜联合胆道镜取石T管引流术,其中A组使用免打结倒刺缝线连续缝合技术,B组使用可吸收缝线连续缝合技术,C组使用可吸收缝线间断缝合技术。比较三组患者的胆总管初始压力、回复末压力、注水最大压力及手术时间,比较三组患者术后第1、7天时的胆总管压力,术后临床指标(首次肛门排气时间、住院时间、肠鸣音恢复时间),并统计三组术后7 d内的胆瘘发生率。结果三组胆总管初始压力、回复末压力比较差异未见统计学意义(P>0.05);A组注水最大压力高于B、C组,差异有统计学意义(P<0.05);C组手术时间长于A、B组,差异有统计学意义(P<0.05);A、B组手术时间比较,差异未见统计学意义(P>0.05)。术后第1、7天,A组胆总管压力低于B、C组(P<0.05)。三组首次肛门排气时间、肠鸣音恢复时间比较,差异未见统计学意义(P>0.05);A组住院时间短于B、C组,差异有统计学意义(P<0.05)。A、B、C三组胆瘘发生率[6.06%(2/33)、12.12%(4/33)、12.12%(4/33)]比较,差异未见统计学意义(P>0.05)。结论三种缝合技术在胆总管结石手术中各有优劣,可根据患者实际情况选择合适的缝合方法。Objective To compare the clinical application effects of different suture techniques in laparoscopy combined with choledochoscopy lithotomy and T-tube drainage for common bile duct stones.Methods This study adopted a prospective analysis method.A total of 99 patients with common bile duct stones who were scheduled to undergo laparoscopy combined choledochoscopy lithotomy and T-tube drainage surgery in Jiaozuo People’s Hospital from January 2021 to January 2022 were selected,and they were divided into group A,group B,and group C by random number table method,with 33 cases in each group.All patients in the three groups underwent laparoscopy combined with choledochoscopy for stone extraction and T-tube drainage,the group A was treated by knotless barbed continuous suture technology,group B was treated by absorbable continuous suture technology,and group C was treated by absorbable intermittent suture technology.The initial pressure of common bile duct,the end of recovery pressure,the maximum pressure of water injection and the operation time were compared among the three groups.The pressure of common bile duct of the three groups were compared on the 1st and 7th days after operation.The clinical indicators(the time of first anal exhaust,hospital stay and recovery time of bowel sounds)were compared among the three groups after surgery;and the 7-day postoperative incidence of biliary fistula of the three groups were counted.Results There was no statistical significant difference in the initial pressure and the end of recovery pressure of the common bile duct among the three groups(P>0.05).The maximum pressure of water injection in group A was significantly higher than that in group B and group C(P<0.05).The operation time of group C was longer than that of group A and group B(P<0.05);there was no statistical significant difference in the operation time between group A and group B(P>0.05).On the 1st and 7th days after surgery,the pressure of the common bile duct in group A was significantly lower than that in group B

关 键 词：胆结石 腹腔镜联合胆道镜取石T管引流术 缝合技术 

分 类 号：R657.4[医药卫生—外科学]