临时支撑管辅助下腹腔镜一期缝合在治疗细径胆总管结石的应用  

Application of Laparoscopic Primary Suture Assisted by Temporary Support Tube in the Treatment of Fine Diameter Choledocholithiasis

作　　者：杨楠[1] 王庆大 孙楼宗 Yang Nan;Wang Qingda;Sun Louzhong(Department of Hepatobiliary Surgery,The First People's Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院肝胆外科,四川自贡643000

出　　处：《四川医学》2024年第4期405-409,共5页Sichuan Medical Journal

摘　　要：目的 探讨胆总管内置入临时支撑管辅助下完成一期缝合在腹腔镜细径胆总管探查术中的可行性及安全性。方法 回顾分析我院肝胆科2019年3月至2023年3月63例胆总管直径在0.5~0.7 cm范围内的细径胆总管结石合并胆囊结石患者,采用腹腔镜下胆总管内置入临时支撑管辅助一期缝合的患者的临床资料。结果 63例细径胆总管结石患者均完成腹腔镜下临时支撑管辅助一期缝合。手术时间平均(86.5±26.2)min,术中胆总管一期缝合时间平均(16.5±3.2)min,术后3例患者发生胆漏,于术后3~7 d停止。术后3个月、6个月、12个月门诊复查B超及肝功,未发现患者并发胆总管狭窄及肝功异常及胆总管结石复发。结论 对于细径胆总管结石合并胆囊结石患者,采用腹腔镜下胆总管内置入临时支撑管辅助一期缝合,是安全可行,具有临床应用价值。Objective To investigate feasibility and safety of one-stage suture assisted by temporary support tube placement in common bile duct in laparoscopic fine duct exploration.Methods From March 2019 to March 2023,clinical data of 63 patients with fine diameter choledocholithiasis with common bile duct diameter ranging from 0.50.7 cm combined with cholecystolithiasis in our hospital were retrospectively analyzed.Temporary support tube was inserted into the common bile duct under laparoscopy to assist primary suture.ResultsAll63 cases of fine diameter choledocholithiasis underwent laparoscopic temporary support tube assisted primary suture.The average operative time was(86.5+26.2)min,and the average intraoperative primary suture time was(16.5±3.2)min.Postoperative bile leakage occurred in 3 patients,which stopped 3 to 7 days after surgery.After 3,6 and 12 months,outpatient reexamination of B ultrasound and liver function,there was no complication of choledochal stenosis,significant abnormal liver function and choledochal stone recurrence.Conclusion For patients with fine diameter choledocholithiasis combined with cholecystolithiasis,it is safe,feasible and clinically valuable to insert temporary support tube into common bile duct under laparoscopy to assist primary suture.

关 键 词：腹腔镜胆总管一期缝合 细径胆总管结石 临时支撑管 

分 类 号：R657.42[医药卫生—外科学]