腹腔镜胆总管探查一期缝合术适应证及胆漏防治4100例临床经验  

Clinical Experience of Indications and Prevention of Bile Leakage in 4100 Cases of Laparoscopic Common Bile Duct Exploration and Primary Suture Surgery

作　　者：张光全[1] 郑柳[1] 谢亮[1] 姚波[1] 侯金平 Zhang Guangquan;Zheng Liu;Xie Liang(Hepatobiliary Department of Chengdu Sixth People′s Hospital,Chengdu,Sichuan 610051,China)

机构地区：[1]成都市第六人民医院肝胆外科,四川成都610051

出　　处：《四川医学》2024年第7期776-779,共4页Sichuan Medical Journal

摘　　要：目的探讨腹腔镜胆总管探查(LCBDE)一期缝合适应证及胆漏并发症防治技术。方法回顾性分析2000年1月至2023年8月我院收治的4100例胆囊结石合并胆总管结石行LCBDE一期缝合术患者的临床资料,包括病例纳入标准、技术方法及胆漏并发症的防治经验。结果4100例LCBDE一期缝合术均顺利完成,无中转开腹。术后3991例(97.34%)恢复顺利,109例(2.66%)发生胆漏。其中101例(2.46%)漏胆不伴腹膜炎50~200 ml/d,乳胶管引流1~2周自愈,8例(0.19%)胆漏伴腹膜炎再次手术胆总管置T管及腹腔引流术,本组无死亡病例。结论胆总管结石采用LCBDE一期缝合术的方法是安全有效而且有优势的选择术式。Objective To explore the indications for primary suture of laparoscopic common bile duct exploration(LCBDE)and the prevention and treatment techniques for bile leakage complications.Methods From January 2000 to August 2023,retrospective analysis of clinical data of 4100 patients with gallbladder stones and common bile duct stones who underwent LCBDE primary suture surgery in our hospital,including inclusion criteria,technical methods,and experience in preventing and treating bile leakage complications.Results 4100 LCBDE primary sutures were successfully completed without any conversion to open surgery.3991 cases(97.34%)recovered smoothly after surgery,and 109 cases(2.66%)had bile leakage.Among them,101 cases(2.46%)had bile leakage without peritonitis 50~200 ml/d latex tube drainage for 1~2 weeks,and 8 cases(0.19%)had bile leakage with peritonitis and underwent reoperation with T-tube placement and abdominal drainage in the common bile duct.There were no deaths in this group.Conclusions The method of LCBDE primary suture for common bile duct stones would be a safe,effective,and advantageous surgical option.

关 键 词：腹腔镜胆总管探查 适应证 一期缝合 胆漏 

分 类 号：R657.42[医药卫生—外科学]