腹腔镜胆总管探查一期缝合和T管引流术的对照分析

目的 探讨腹腔镜胆总管探查术（LCBDE）后一期缝合术的安全性、有效性。方法 回顾性分析行LCBDE68例患者的临床资料，按手术方式不同分为一期缝合组（36例）、T管引流组（32例），比较两组的疗效。结果 两组手术时间、腹腔引流时间及术后并发症如胆漏、胆汁性腹膜炎、结石残余、急性胰腺炎等比较差异无统计学意义（P均〉0．05），住院时间、术后补液量一期缝合组均少于T管引流组（P均〈0．05）；术后随访1～4年，两组结石复发、胆管狭窄发生率差异无统计学意义（P〉0．05）。结论 LCBDE后一期缝合、T管引流术均安全、有效，一期缝合术疗效优于T管引流术。

Comparative analysis between primary suture and T-tube drainage on common bile duct in la- paroscopic exploration

Objective To investigate the safety and efficiency of primary suture on common bile duct in laparoscopic common bile duct exploration(LCBDE).Methods From June 2002 to June 2005,LCBDE was performed on 68 cases of common bile duct calculi.Of which,36 cases were performed primary suture on common bile duct(closure group),while 32 cases were performed common bile duct T-tube drainage(drainage group).Results There was no significant difference in term of operation time and abdominal drainage time between two groups(P>0.05).Compared with drainage group,the hospital stay after operation in closure group was shorter,and fluid supplement amount was less(P<0.05).Bile leakage after operation was seen in 2 cases(2/36)in closure group,while 1 case(1/32) in drainage group(P>0.05).Bile duct retained stones was seen in 1 case(1/36)in closure group,while 2 cases(2/32) in drainage group(P>0.05).Bile duct recurrent calculi was seen in 1 case(1/36)in closure group,while 2 cases(2/32) in drainage group(P>0.05).Bile peritonitis was seen in 1 case after extubation.There was no extrahepatic duct stenosis in two groups.Conclusion Primary suture on common bile duct in LCBDE is safe for common bile duct calculi.