广州医药 ›› 2019, Vol. 50 ›› Issue (1): 49-51.DOI: 10.3969/j.issn.1000-8535.2019.01.012

• 论著 • 上一篇    下一篇

腹腔镜下胆总管切开取石中胆管一期缝合治疗胆总管结石的临床效果观察

刘晖, 吴青松, 赵家锋, 张小龙, 楚春香   

  1. 韶关市粤北人民医院肝胆外科(韶关 512025)
  • 收稿日期:2018-08-18 出版日期:2019-01-20 发布日期:2021-12-21

Clinical effect of primary suture in laparoscopic choledochotomy for choledocholithiasis

LIU Hui, WU Qingsong, ZHAO Jiafeng, ZHANG Xiaolong, CHU Chunxiang   

  1. Hepatobiliary Surgery,Yuebei People's Hospital,Shaoguan 512025,China
  • Received:2018-08-18 Online:2019-01-20 Published:2021-12-21

摘要: 目的 观察腹腔镜下胆总管切开取石术中胆管一期缝合治疗胆总管结石的临床效果。方法 研究对象选取我院2016年3月—2017年3月术前诊断为胆总管结石且符合纳入标准的患者92例,采用随机法,将其分为一期缝合术组和T管引流术组各46例,两组患者均行腹腔镜下胆总管切开取石术,一期缝合术组行术中胆管一期缝合,T管引流术组行术中胆管T管引流。比较两组手术相关指标,住院时间,住院费用,术后并发症的发生率。结果 一期缝合术组在减少手术出血量、促进切口恢复、预防切口感染的发生率上优于T管引流术组(P < 0.05);在住院时间、住院费用以及术后并发症的发生率上低于T管引流术组(P < 0.05)。结论 本次研究结果表明腹腔镜下胆总管切开取石术中胆管一期缝合的临床效果优于T管引流,可有效减少手术并发症,缩短病人的住院时间,是治疗胆总管结石理想的选择。

关键词: 胆总管结石, 腹腔镜手术, 取石术, 一期缝合, T 管引流

Abstract: Objective To observe the clinical effect of primary suture in the treatment of common bile duct stones under laparoscopic common bile duct incision. Methods The subjects were enrolled in our hospital from March 2017 to March 2018. 92 patients with choledocholithiasis and met the inclusion criteria, were randomly divided into one-stage suture group and T-tube drainage group. Surgery-related indicators,length of hospital stay,hospitalization costs,and incidence of postoperative complications were compared. Results In the first-stage suture group,the incidence of surgical bleeding reduction,postoperative incision recovery,and prevention of wound infection were better than those in the T-tube drainage group (P < 0.05). The incidence of hospitalization,hospitalization,and postoperative complications were lower in the first-stage suture group than in the T-tube drainage group(P < 0.05). Conclusion The clinical effect of one-stage suture in laparoscopic common bile duct incision and stone removal is better than T-tube drainage,which may effectively reduce surgical complications and shorten the hospitalization time of patients. It is an ideal choice for the treatment of common bile duct stones.

Key words: Choledocholithiasis, Laparoscopic operation, Lithotomy, Primary suture, T tube drainage