胆总管结石患者腹腔镜胆总管探查术中应用“三针法”缝合方案的临床研究  

Clinical study on the application of"three-needle"suture scheme in laparoscopic choledocholithiasis

作　　者：姜宁宁 蔺艳丽 陈惠明 Jiang Ningning;Lin Yanli;Chen Huiming(Department of General Surgery,Shaanxi Rehabilitation Hospital,Xi'an Shaanxi province 710065,China)

机构地区：[1]陕西省康复医院普外科,西安710065

出　　处：《中华普外科手术学杂志（电子版）》2024年第5期531-534,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省重点研发计划项目(2021SF-150)。

摘　　要：目的:探讨胆总管结石患者腹腔镜胆总管探查术中应用“三针法”缝合方案的效果。方法:前瞻性选取2020年6月至2023年5月接受腹腔镜胆总管探查术的胆总管结石患者105例,依据随机数字表法分为常规组(采用常规胆总管缝合术)53例与三针组(采用“三针法”缝合胆总管)52例。采用SPSS25.0软件分析数据,手术相关指标、术后恢复情况、术后疼痛情况等计量资料采用(x±s)表示,行独立样本t检验;计数资料并发症发生情况行χ^(2)检验。P<0.05为差异有统计学意义。结果:三针组胆总管缝合时间、手术时间均短于常规组(P<0.05);两组患者术后引流管拔除时间、术后下床活动时间、住院时间、医疗费用、术后1d、3d的视觉模拟疼痛评分(VAS)和术后并发症总发生率比较差异无统计学意义(P>0.05),但三针组胆瘘发生率低于常规组(P<0.05)。结论:采用“三针法”缝合方案可缩短胆总管结石患者腹腔镜胆总管探查术的缝合时间及手术时间,降低术后胆瘘发生率,且不会增加医疗费用,值得临床推广应用。Objective:To investigate the effect of"three-needle"suture in laparoscopic choledocholithiasis.Methods:A total of 105 patients with choledocholithiasis who received laparoscopic choledochal exploration from June 2020 to May 2023 were prospectively selected and divided into the conventional group(with conventional choledochal suture)(53 cases)and the three-needle group(with"three-needle suture")(52 cases)according to random number table method.SPSS25.0 software was used to analyze the data.Surgical indicators,postoperative recovery,postoperative pain and other measurement data were expressed by(x±s),and independent sample t test was performed.The incidence of complications was examined byχ^(2) test.P<0.05 was considered statistically significant.Results:The time of common bile duct suture and operation in the three-needle group were shorter than those in the conventional group(P<0.05).There was no significant difference in postoperative drainage tube removal time,postoperative ambulation time,hospital stay,medical cost,visual analogue pain scale(VAS)of 1d and 3d after surgery and the total incidence of postoperative complications between the two groups(P>0.05),but the incidence of biliary fistula in the three-needle group was lower than that in the conventional group(P<0.05).Conclusion:The"three-needle"suture scheme can shorten the suture time and operation time of laparoscopic choledocholithiasis in patients with choledocholithiasis,reduce the incidence of postoperative biliary fistula,and does not increase medical costs,and is worthy of clinical application.

关 键 词：胆总管结石 腹腔镜胆总管探查术 三针法缝合 胆瘘 

分 类 号：R657.4[医药卫生—外科学]