摘要
目的:对比分析腹腔镜胆囊切除+胆总管切开取石后胆总管一期连续缝合与间断缝合治疗胆总管结石的临床疗效。方法:回顾分析2018年10月至2020年9月为73例胆总管结石患者行腹腔镜胆囊切除+胆总管切开取石+一期缝合的临床资料,其中对照组包括39例行胆总管一期间断缝合的患者,观察组包括34例行胆总管一期连续锁边缝合的患者。对比分析两组术中出血量、手术时间、术后排气时间、术后住院时间、腹腔引流时间、术后胆漏、发热及电解质紊乱发生率及术后胆总管狭窄、结石复发情况。结果:两组术中出血量、术后排气时间及电解质紊乱发生率差异无统计学意义(P>0.05)。观察组手术时间、术后住院时间、腹腔引流时间短于对照组,术后胆漏、发热发生率低于对照组,差异有统计学意义(P<0.05)。术后6个月复查,两组均无胆总管狭窄及结石复发。结论:腹腔镜胆总管切开取石后一期连续锁边缝合相较间断缝合具有明显优势,可缩短手术时间、术后住院时间,加快术后康复,减少并发症的发生,值得临床推广应用。
Objective:To compare and analyze the clinical efficacy of one-stage continuous locking suture and intermittent suture of common bile duct after laparoscopic cholecystectomy and common bile duct exploration.Methods:Clinical data of 73 patients who suffered from choledocholithiasis and underwent laparoscopic cholecystectomy,choledocholithotomy and primary suture from Oct.2018 to Sep.2020 were retrospectively analyzed.Among them,39 patients who underwent primary intermittent suture were divided into the control group,and 34 patients who underwent primary continuous locking suture were divided into the observation group.The indicators of intraoperative blood loss,operation time,postoperative exhaust time,postoperative hospitalization time,drainage time,bile leakage,fever,electrolyte imbalance,the recurrence of common bile duct stones and the common bile duct stenosis after surgery were compared between the two groups.Results:The intraoperative blood loss,postoperative exhaust time and electrolyte imbalance after surgery were similar in the two groups(P>0.05).But the operation time,drainage time and postoperative hospitalization time was less in observation group,at the same time the incidence of bile leakage and fever was significantly reduced(P<0.05).There were no recurrence of common bile duct stones and the common bile duct stenosis in two groups 6 months after operation.Conclusions:After laparoscopic choledocholithotomy,one-stage continuous locking suture has obvious advantages over intermittent suture,it can shorten the operative time and postoperative hospital stay,accelerate postoperative rehabilitation,reduce complications,and is worthy of clinical promotion.
作者
陈殿玉
唐俊伟
徐全宏
CHEN Dian-yu;TANG Jun-wei;XU Quan-hong(Department of Hepatobiliary Surgery,Tianchang People’s Hospital,Tianchang 239300,China;Department of Colorectal Surgery,the First Affiliated Hospital of Nanjing Medical University)
出处
《腹腔镜外科杂志》
2022年第7期535-538,共4页
Journal of Laparoscopic Surgery
