节点文献
腹腔镜胆总管探查一期缝合术的临床应用研究
Clinical Aplication of Laparoscopic Common Bile Duct Exploration with Primary Closure
【作者】 茹东跃；
【导师】 刘亚辉；
【作者基本信息】 吉林大学 ， 外科学， 2012， 硕士
【摘要】 目的：探讨腹腔镜胆总管探查一期缝合术的可行性及效果。方法：回顾性分析我院于2010年1月至2011年1月成功实施腹腔镜胆总管探查术(laparoscopic common bile duct exploration,LCBDE)患者的临床资料，分别比较一期缝合术(primary suture, PS)(PS组)组66与T管引流术(T-tubedrainage,TD)(TD组)组66例的临床效果。结果：两组手术时间、腹腔引流时间、术后胆漏发生率无统计学意义（P>0.05），而术后胃肠道恢复时间、术后住院时间，PS组较TD组有明显差异（P <0.05）。PS组术后出现轻微胆漏2例，给予通畅引流后自愈。TD组拔管后出现胆漏3例，给于保守、对症治疗后治愈。术后回访3~12个月，平均8个月，均未出现胆汁漏、结石复发、胆道狭窄。两组均无死亡病例。结论：腹腔镜胆总管探查一期缝合是可行的，可避免因留置放置T管引起的并发症，减轻患者痛苦，并具有创伤小、痛苦轻、恢复快等微创特点，值得进一步推广。
【Abstract】 Objective:To compare laparoscopic common bile duct exploration of theeffect primary closure and of T-tube drainage,laparoscopic common bile duceexploration suture of clinical significance.Mehtods:A retrospective analysis of our hospital and ourHospital in January2010to January2011the successful implementation oflaparoscopic common bile duct exploration clinical data,and compares primaryclosure group of66patients with T tube drainage group of66patients withclinical effects.Results: Mean operating time, intraperitoneal drainage duration,postoperative bile leakage was not significant(P>0.05),and postoperativegastrointestinal recovery time,postoperative hospital stay,PS group weresignificantly different than the TD group(P<0.05).PS group were minor bileleakage in2case,after the self-healing for unobstructed drainage.TD groupafter extubation3cases of bile leakage,to conservative,symptomatic treatmentcured.After returning from3to12months,an average of8months,twogroups of bile leakage were not there,gallstone recur-rence of bile ductstricture.There were no deaths.Conclusion: The primary closure in the common bile duct is safe andfeasible.This method have less impact in patients with primary closure.It haveless pain.Better reflect the superiority of laparoscopic techniques.