胆囊管细管引流在腹腔镜胆总管一期缝合术的应用

doi:10.16139/j.1007-9610.2019.03.015

摘要/Abstract

摘要： 目的探讨胆囊管细管引流用于经脐入路腹腔镜经胆囊管汇合部探查胆总管一期缝合术。方法回顾性分析2013年8月至2018年10月,在我院225例实施经脐入路腹腔镜胆囊切除术和经胆囊管汇合部行胆总管切开取石治疗胆囊结石合并胆总管结石病人的临床资料,其中119例术中经胆囊管放置胆总管细管引流+胆总管一期缝合（引流组）,106例直接行胆总管一期缝合（缝合组）,比较两组病人手术时间、腹腔引流管放置时间、术后住院时间、住院费用和术后并发症发生等情况。结果引流组腹腔引流管放置时间、术后住院时间和住院费用显著低于缝合组,差异有统计学意义（P<0.05）。两组手术时间比较,差异无统计学意义（P>0.05）。引流组术后胆漏发生率（8.40%）低于缝合组（16.04%）,差异有统计学意义（P<0.05）。两组无其他并发症。结论胆囊管细管引流应用于经脐入路腹腔镜经胆囊管汇合部胆总管探查一期缝合术安全、有效。

关键词: 经脐入路内镜手术, 腹腔镜胆总管探查术, 一期缝合术, 胆道引流

Abstract: Objective To explore cystic duct drainage in transumbilical laparoscopic common bile duct exploration through cystic duct common bile duct junction with primary closure. Methods A total of 225 patients with a diagnosis of cholecystolithiasis and choledocholithiasis who underwent transumbilical laparoscopic cholecystectomy and common bile duct exploration through cystic duct common bile duct junction with primary closure between August 2013 and October 2018 were retrospectively analyzed and the data were collected. Of these, 119 cases had bile drainage through cystic duct with primary closure as drainage group, while 106 cases had only primary closure as closure group. Operative time, abdominal drainage time, postoperative hospital stay, hospital cost and postoperative complications were compared between two groups. Results Abdominal drainage time, postoperative hospital stay and hospital cost in drainage group were significantly lower than those in closure group (P< 0.05). There was no significant difference in operative time between two groups (P>; 0.05). The rate of postoperative bile leak(8.40%) in drainage group was less than that (16.04%) in closure group and the difference was statistical significantly (P< 0.05). There was no other any complication in two groups. Conclusions Cystic duct drainage in transumbilical laparoscopic common bile duct exploration through cystic duct common bile duct junction with primary closure would be safe and effective.

Key words: Transumbilical endoscopic surgery, Laparoscopic common bile duct exploration, Primary closure, Biliary drainage

中图分类号:

R657.4⁺2

徐国权, 顾春飞, 郁林海, 冯林松, 褚永悦, 朱海峰, 方胜利. 胆囊管细管引流在腹腔镜胆总管一期缝合术的应用[J]. 外科理论与实践, 2019, 24(03): 249-253.

XU Guoquan, GU Chunfei, YU Linhai, FENG Linsong, CHU Yongyue, ZHU Haifeng, FANG Shengli.. Cyst duct drainage in laparoscopic common bile duct exploration with primary closure[J]. Journal of Surgery Concepts & Practice, 2019, 24(03): 249-253.

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