Objective To discuss the safety and clinical efficacy of laparoscopic common bile duct exploration and primary suture in the treatment of cholelithiasis.Method A retrospective analysis of our hospital from March 2012 to March 2013admitted to parallel laparoscopic choledocholithotomy and primary suture of the clinical data of 43 cases of patients,bile leakage,bile duct stricture,biliary residual stones and complications such as postoperative cases.Result All patients in the laparoscopic operation successfully.The operative time ranged from 60 to 200 min,the average operation time was 101min,the amount of bleeding was 10 ～40ml,the average amount of bleeding 15ml,the hospitalization time was 5 to 12 days,the average hospitalization time was 8 days,2 cases of patients with biliary fistula,abdominal drainage volume of about 20 ～ 60ml/d.After 2 to 4 days of non biliary drainage is less than 10ml,respectively after 3 days and 5 days of abdominal ultrasound showed no obvious peritoneal effusion after drainage,cured.The follow-up time ranged from 3 to 24 months,the average follow-up time of 17 months,no abnormal liver function,bile duct stricture,biliary residual stones and other serious complications.Conclusion Choledocholithotomy and primary suture in laparoscopic common bile duct is safe and feasible,but to strictly grasp the indications,with shorter hospitalization time,quick postoperative recovery,improve the comfort of patients after surgery,embodies the advantages of minimally invasive laparoscopic surgery,it is worth to be promoted.%目的 探讨腹腔镜下胆总管切开取石一期缝合术治疗胆石症的可行性及临床应用效果.方法 回顾性地分析我院自2012年3月～2015年3月收住并行腹腔镜下胆总管切开取石一期缝合术的43例患者的临床资料,观察患者术后发生胆漏、胆总管狭窄、胆道残余结石等并发症的情况.结果 所有患者均在腹腔镜下顺利完成手术,手术时间60 ～ 200 min,平均手术时间101 min,出血量10～40ml,平均出血量15ml,住院时间5～12天,平均住院时间8天,2例患者术后发生胆漏,腹腔引流量约20～60ml/d,术后2～4天非胆汁性引流液小于10ml,分别于术后3天、5天行腹腔超声示腹腔无明显积液后拔除腹腔引流管,治愈出院.随访时间3～24个月,平均随访时间17个月,无肝功异常、胆总管狭窄、胆道残余结石等严重并发症发生.结论 腹腔镜下胆总管切开取石一期缝合术是安全可行的,但需严格把握其适应证,具有住院时间短,术后恢复快等优点,提高了患者术后舒适感,体现了腹腔镜微创手术的优势,值得临床推广.
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