腹腔镜胆总管一期缝合经胆囊管置管胆道外引流的作用

发布时间：2018-04-13 14:44

本文选题：胆总管切开 + 腹腔镜　；参考：《中国微创外科杂志》2017年06期

【摘要】：目的探讨腹腔镜胆总管一期缝合术中经胆囊管放置细导管(F5输尿管导管)胆道外引流的有效性及安全性。方法回顾性分析2013年2月~2016年3月59例胆囊结石合并胆总管结石患者的临床资料,行腹腔镜胆囊切除+胆总管切开取石一期缝合,经胆囊管放置细导管行胆道外引流。结果全组均手术成功,术后胆汁引流量30~570 ml/d,术后无胆漏、胆管炎、胰腺炎等并发症。术后6~8 d拔管57例,10~11 d拔管2例,无拔管并发症发生。术后住院时间(9.1±2.0)d。全组随访5个月~3年,平均16个月,B超检查无胆管残余结石,肝功能均正常。结论经胆囊管放置细导管胆道外引流,是一种简易、安全及有效的胆道外引流方式,可以消除胆总管一期缝合术后胆漏的潜在风险。
[Abstract]:Objective to evaluate the efficacy and safety of laparoscopic choledochus primary suture (LCS) for external drainage of bile duct by placement of thin duct F5 ureteral duct (F5 ureteral duct) in laparoscopic choledochotomy.Methods the clinical data of 59 patients with cholecystolithiasis complicated with choledocholithiasis from February 2013 to March 2016 were analyzed retrospectively. Laparoscopic cholecystectomy and choledocholithiasis were performed with primary suture.Results all the patients were successfully operated, the postoperative bile drainage was 30570ml / d, and there were no biliary leakage, cholangitis, pancreatitis and other complications.There were no extubation complications in 57 patients (10 / 11 days) after extubation at 6 and 8 days after extubation.Postoperative hospitalization time was 9.1 卤2.0 days.All patients were followed up for 5 months to 3 years (mean 16 months). There were no residual stones in bile duct and normal liver function.Conclusion it is a simple, safe and effective external drainage of bile duct to place thin duct through gallbladder duct, which can eliminate the potential risk of bile leakage after primary suture of common bile duct.
【作者单位】：江苏省丹阳市人民医院普通外科;
【基金】：镇江市卫生科技重点项目(SHW2015021) 镇江市社会发展科技计划项目(FZ2015073)
【分类号】：R657.4

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