胆总管结石患者腹腔镜手术后不同胆总管缝合方案对比  

Comparison of different common bile duct suture schemes in patients with choledocholithiasis after laparoscopic surgery

作　　者：黄子臻 季予江 李连涛 Huang Zi-zhen;Ji Yu-jiang;Li Lian-tao(Department of Hepatobiliary and Pancreatic Minimally Invasive Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院肝胆胰微创外科,河南郑州450000

出　　处：《四川生理科学杂志》2025年第1期37-40,共4页

摘　　要：目的:比较胆总管结石患者腹腔镜手术后应用不同胆总管缝合方案的效果。方法:回顾性收集2021年3月至2022年9月医院69例行腹腔镜手术的胆总管结石患者的临床资料。根据缝合方案的不同分为对照组(常规胆总管缝合技术,34例)和观察组(三针连续法缝合胆总管技术,35例),比较两组围术期指标、术后肠胃功能恢复情况、营养代谢指标[血清白蛋白(ALB)、前白蛋白(PAB)、血红蛋白(Hb)水平]、生活质量[生存质量测定量表(QOL-100)]。统计两组术后并发症。结果:对照组术后引流时间、住院时间、胆管缝合时间均长于观察组(P<0.05)。对照组术后排便时间、肠鸣音恢复时间、首次排气时间均长于观察组(P<0.05)。术后3 d,对照组Hb、PAB、ALB水平低于观察组(P<0.05)。术后1m时,对照组QOL-100评分低于观察组(P<0.05);对照组术后并发症发生率高于观察组(P<0.05)。结论:与常规胆总管缝合技术相比,腹腔镜手术中采用三针连续法缝合胆总管技术能够缩短胆总管结石患者胆管缝合时间、手术时间、术后引流时间、住院时间,改善患者肠胃功能以及营养代谢功能,提高患者生活质量,且能够减少术后并发症发生。Objective:To compare the effects of different common bile duct suture schemes in patients with choledocholithiasis after laparoscopic surgery.Methods:The clinical data of 69 patients with choledocholithiasis who underwent laparoscopic surgery from March 2021 to September 2022 were retrospectively collected.They were divided into control group(conventional common bile duct suture technique,34 cases)and observation group(three-needle continuous common bile duct suture technique,35 cases)according to different suture schemes.The perioperative indexes,postoperative gastrointestinal function recovery,nutritional metabolism indexes(serum albumin(ALB),prealbumin(PAB),hemoglobin(Hb)levels)and quality of life(QOL-100)of the two groups were compared.The postoperative complications of the two groups were analyzed.Results:The postoperative drainage time,hospital stay time and bile duct suture time of control group were longer than those of observation group(P<0.05).The postoperative defecation time,bowel sound recovery time and first exhaust time of control group were longer than those of observation group(P<0.05).After 3 days,the levels of Hb,PAB and ALB in control group were lower than those in observation group(P<0.05).One month after operation,the QOL-100 score of control group was lower than that of observation group(P<0.05).The incidence of postoperative complications in control group was higher than that in observation group(P<0.05).Conclusion:Compared with the conventional common bile duct suture technique,the three-needle continuous method of common bile duct suture in laparoscopic surgery can shorten the bile duct suture time,operation time,postoperative drainage time and hospital stay of patients with common bile duct calculus,improve the gastrointestinal function and nutritional metabolism function of patients,improve the quality of life of patients,and reduce the occurrence of postoperative complications.

关 键 词：胆总管结石 腹腔镜手术 胆总管缝合 

分 类 号：R657.4[医药卫生—外科学]