摘要
目的:探讨腹腔镜经胆囊管胆总管汇合部切开取石一期缝合的安全性及可行性。方法:回顾性分析航天中心医院肝胆外科行腹腔镜经胆囊管胆总管汇合部切开胆总管探查的64例病人的临床资料。根据是否放置T管将其分为一期缝合组31例和放置T管组33例,观察两组手术时间、术后排气时间、术后住院天数、并发症发生率等指标。结果:一期缝合组术后排气时间、术后住院天数均短于放置T管组,一期缝合组术后6wk腹痛发生率低于放置T管组,差异具有统计学意义(P<0.05),两组病人手术时间、胆瘘发生率比较差异无显著性(P>0.05)。两组病人术后均未出现胆管狭窄。结论:对于胆总管内径增宽不明显、胆总管炎症较轻、Oddi’s括约肌功能良好的病人,腹腔镜经胆囊管胆总管汇合部切开取石一期缝合方法是安全可行的。
Objective:To evaluate the feasibility and safety of laparoscopic choledocholithotomy through cystiC-common bile duct juncture incision in treatment of choledocholithiasis.Methods:A total of 64 patients with choledocholithiasis underwent laparoscopic common bile duct exploration(LCBDE)during the hepatobiliary department of aerospace center hospital,and were done through a cystiC-common bile duct juncture incision.The patients were divided into primary suture group(n=31)and T-tube drainage group(n=33)according to different processing methods of bile duct incision.Then we analyzed the operation time,postoperative hospital stays,postoperative exhaust time,and complications between the two groups.Results:The postoperative hospital stays and exhaust time in primary suture group was shorter than those in T-tube drainage group,and primary suture group had a lower abdominal pain occurrence 6 weeks postoperatively(P<0.05).It bears no statistical difference between the two groups as in operation time and occurrence of bile leakage(P>0.05).No biliary stricture was found in either of the two groups.Conclusion:For patients with not significantly dilated common bile duct,moderate cholangitis,and good Oddi’s sphincter function,laparoscopic choledocholithotomy through cystiC-common bile duct juncture incision and primary suture is feasible and safe.
作者
胡浩
李会星
赵玮
秦玉刚
欧阳才国
HU Hao;LI Hui-xing;ZHAO Wei(Hepatobiliary Surgery Department,Aerospace Center Hospital,Beijing 100049 China)
出处
《内蒙古医科大学学报》
2020年第1期24-26,30,共4页
Journal of Inner Mongolia Medical University
关键词
胆总管结石
经胆囊管胆总管汇合部切开
一期缝合
腹腔镜
choledocholithiasis
cystiC-common bile duct juncture incision
primary suture
laparoscopy
作者简介
胡浩(1985-),男,航天中心医院肝胆外科主治医师。
