腹腔镜胆总管切开取石一期缝合安全性临床分析

发布时间：2018-04-19 23:31

本文选题：腹腔镜 + 胆总管结石　；参考：《重庆医学》2017年20期

【摘要】：目的探讨腹腔镜下胆总管切开取石一期缝合安全性及可行性。方法回顾性分析2010年3月至2015年10月中山大学孙逸仙纪念医院腹腔镜下胆总管切开取石185例患者的临床资料,根据胆总管切口不同处理方式分为一期缝合组和T管引流组,观察两组手术时间、术中出血量、术后住院时间、术后并发症等指标。结果两组手术均获成功,无中转开腹。一期缝合组和T管引流组手术时间、术中出血量、术后并发症比较,差异无统计学意义(P0.05)。一期缝合组术后住院时间较T管引流组明显缩短(P0.01),两组术后随访未见结石复发及胆道狭窄。结论严格把握手术的适应证,选择正确缝合材料,具备娴熟的操作技能,腹腔镜下胆总管切开取石一期缝合是安全可行性的,能避免放置T管相关并发症风险,术后住院时间短、生活质量提高。
[Abstract]:Objective to investigate the safety and feasibility of laparoscopic choledocholithotomy and primary suture. Methods from March 2010 to October 2015, 185 patients with choledocholithiasis underwent laparoscopic choledocholithotomy in Sun Yat-sen Memorial Hospital of Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. The operative time, intraoperative bleeding volume, postoperative hospitalization time and postoperative complications were observed. Results the operation was successful in both groups, and there was no conversion to open operation. There was no significant difference between primary suture group and T tube drainage group in operation time, blood loss and postoperative complications (P 0.05). The hospitalization time of primary suture group was significantly shorter than that of T-tube drainage group. Conclusion it is safe and feasible to strictly grasp the indication of operation, select the correct suture material and have skilled operation skills. The primary suture of choledocholithotomy under laparoscope is safe and feasible, and can avoid the risk of complications associated with the placement of T-tube. The hospital stay was short and the quality of life was improved.
【作者单位】：海南省农垦总医院肝胆胰外科;广东省中山大学孙逸仙纪念医院肝胆外科;中国人民解放军驻乌鲁木齐铁路局军代处;
【分类号】：R657.42

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