腹腔镜胆总管探查术后一期缝合的临床应用

摘要

目的 研究腹腔镜胆总管探查(LCBDE)术后胆总管一期缝合的安全性及临床应用价值.方法 分析140例腹腔镜胆总管切开探查取石术的临床资料,对比研究胆总管一期缝合(实验组,n=70)与T管引流(对照组,n=70)的临床效果.结果 两组手术时间、腹腔引流时间、肝功能恢复、黄疸消退、术后胆瘘、残石率、结石复发等情况差异无统计学意义(P＞0.05);实验组术后肛门排气时间、住院时间较对照组短(P＜ 0.05).结论 只要掌握适应证,LCBDE术后胆总管一期缝合是安全可行的,更避免了留置T管的弊端,值得推广应用.%Objective To investigate the safety and clinical value of primary closure after laparoscopic common bile duct exploration (LCBDE).Methods The clinical data of 140 patients undergoing laparoscopic common bile duct exploration were analyzed.70 cases were primarily closed the common bile ducts (experimental group),while the other 70 cases had T-tube drainage of common bile duct (control group).Results There were no statistical differences in operation time,abdominal drainage time,recovery of liver function,decline of serum bilirubin,postoperative bile leakage,retained bile duct stones,bile duct recurrent stones between the two groups (P ＞ 0.05).Postoperative hospital stay and anal exhaustion time were shorter in the experimental group than in the control group (P ＜ 0.05).Conclusions If only the indication is properly mastered,the primary closure after laparoscopic common bile duct exploration can be safe and feasible.It can avoid the disadvantage of T-tube drainage of common bile duct and is worth being generalized.