单向倒刺线在腹腔镜肝叶切除联合术中胆道探查中的运用

发布时间：2018-03-22 03:31

本文选题：胆道外科手术　切入点：肝切除术　出处：《中国普通外科杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的:探讨单向倒刺缝线在腹腔镜下肝叶切除联合术中胆道探查中应用的安全性及有效性。方法:回顾性分析2014年12月—2015年8月期间24例行腹腔镜肝切除联合术中胆道探查术的患者资料,其中10例采用传统缝线缝合胆管(传统缝线组),14例术中采用倒刺线缝合胆管(倒刺线组),比较两组的相关临床资料。结果:所有患者均手术成功,两组患者术前一般资料、术中出血量、术后并发症发生率(肺部感染)、术后住院时间差异均无统计学意义(均P0.05);但倒刺线组手术时间(230.50 min vs.354.68 min)、胆总管缝合时间(5.33 min vs.33.82 min)、肝管缝合时间(9.04 min vs.25.14 min)均明显少于传统缝线组(均P0.05)。所有患者出院1个月返院行T管造影,拔除T管,无结石残留、胆汁漏、胆管狭窄。结论:单向倒刺缝线用于腹腔镜下肝叶切除联合胆道探查术安全、可行,可吸收倒刺缝线的使用可以降低腹腔镜下缝合难度,缩短手术时间和学习曲线,而不增加胆汁渗漏的风险。
[Abstract]:Objective: to investigate the safety and efficacy of unilateral inverted suture in laparoscopic hepatectomy combined with intraoperative biliary exploration. Methods: 24 cases of laparoscopic hepatectomy from December 2014 to August 2015 were retrospectively analyzed. Data of patients undergoing middle bile duct exploration, Among them, 10 cases were sutured with traditional suture (14 cases in the traditional suture group were sutured with inverted suture line). Results: all the patients were successfully operated, and the general data of the two groups were obtained before operation. Intraoperative bleeding, The incidence of postoperative complications (pulmonary infection, postoperative hospitalization time were not statistically significant (all P 0.05), but the operation time of inverted wire group was 230.50 min vs.354.68, the time of common bile duct suture was 5.33 min vs.33.82, the time of hepatic duct suture was 9.04 min vs.25.14 min). In the traditional suture group (all P0.05), all the patients returned to hospital for T tube angiography one month after discharge. Conclusion: One-way inverted suture is safe and feasible for laparoscopic liver lobectomy combined with bile duct exploration. The use of absorbable inverted suture can reduce the difficulty of laparoscopic suture. Shorten surgical time and learning curve without increasing the risk of bile leakage.
【作者单位】：昆明医科大学第一附属医院肝胆外二科;
【分类号】：R657.4

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