腹腔镜联合胆道镜下胆总管切开取石胆管一期缝合的临床应用

目的:探讨腹腔镜联合胆道镜胆总管切开探查取石术后一期缝合胆总管切口的可行性及临床适应证。方法:回顾分析2004年6月至2012年6月郑州大学第一附属医院应用腹腔镜联合胆道镜胆总管切开探查取石一期缝合胆总管切口128例的治疗效果及预后。结果:手术顺利,无并发症,病人全部痊愈出院,B超复查未见胆道残余结石。结论:在严格掌握适应证的前提下,腹腔镜下胆总管切开纤维胆道镜取石术后行胆总管一期缝合疗效好、安全。该术式创伤小、痛苦轻、恢复快、并发症少等优点体现了微创外科特点,值得临床推广应用。

Clinical application of primary suture of common bile duct after choledochotomy under laparoscope and choledochoscope

Objective： To explore the feasibility and clinical indications of primary suture of common bile duct after biliary exploration and lithotomy under laparoscope and choledochoscope.Methods： Retrospectively analyze the therapeutic effect and prognosis of 128 cases underwent choledochoscopic biliary exploration and lithotomy. The common bile duct was primarily sutured from June of 2004 to June of 2012 in The First Affiliated Hospital of Zhengzhou University. Results： All operations were successful,and had no complications. The patients recovered well and the type-B ultrasonography did not show residual stones. Conclusion： The primary suture of the common bile duct after biliary exploration and lithotomy under laparoscope and choledochoscope was safe and had good curative effect,if strictly follow the indications. This operation was characteristic of minimal invasive,light pain,rapid recovery,fewer complications,which worth more clinical application.