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腹腔镜胆总管探查即时缝合术449例报告
引用本文:扬永洪,熊竹将,陈安平. 腹腔镜胆总管探查即时缝合术449例报告[J]. 中外医疗, 2009, 27(9): 140-141
作者姓名:扬永洪  熊竹将  陈安平
作者单位:1. 四川地质医院,四川成都,610081
2. 成都市第二人民医院肝胆胰外科,四川成都,610017
摘    要:
目的总结运用腹腔镜胆总管探查即时缝合术的治疗经验。方法从1992年6月至2008年8月,运用腹腔镜胆总管探查即时缝合术的手术方式(胆管镜取石术,液电碎石术,导管或球囊扩张术,经胆囊管置入胆管的输尿管导管外引流术,支架内引流术),对449例病人进行治疗。结果426例手术获成功(95%),4例残石经内镜取石治愈,4例残石内镜未取净,12例胆漏经腹腔引流管或内镜鼻胆管引流治愈,2例输尿管导管脱落,1例胰头癌术后15d死亡。其他并发症均经非手术综合疗法治愈。结论只要选择合适的病例,腹腔镜胆总管探查即时缝合术是安全可行的。

关 键 词:腹腔镜  胆总管探查术  即时缝合

Primary Closure of Bile Duct Incision of Laparoscopic Bile Duct Exploration 449 Patients
YANG Yonghong,XIONG Zhujiang,CHEN Anping. Primary Closure of Bile Duct Incision of Laparoscopic Bile Duct Exploration 449 Patients[J]. China Foreign Medical Treatment, 2009, 27(9): 140-141
Authors:YANG Yonghong  XIONG Zhujiang  CHEN Anping
Affiliation:YANG Yonghong, XIONG Zhujiang ,CHEN Anping( Department of Hepatobiliary Surgery,the Second Hospital of Chengdu City,Chengdu 610017,China)
Abstract:
Objective To summarize the method of applying laparoscopic choledochotomy with primary suture for the treatment of choledocholithiasis and bile duct stenosis. Methods From Jun 1992 to Aug 2004, 449 patients were received the therapeutical procedures, i.e. laparoscopic common bile duct exploration was first adopted in order to clear the stones with choledochoscopic exploration, then followed the primary closure of duct incision direct or after balloon dilation, fine duet external drainage via cystic duct,internal drainage of biliary endoprosthesis and stent. Results 426 out of 449 patients had obtained successful duet clearance, or the dilation of the stenosis to reach the expected expansion, easy and smooth drainage of hiliary eudoprosthesis and stent without bile leakage. 4 patients had residual stones then cured with endoscopic sphincterotemy or papillary balloon dilation. 4 patients had residual stones then no cured with endoscopy. 12 patients had bile leakage cured through conservatively. 2 patients had fallen off fine duct via cystic duct cured through to place again fine duct via cystic duct or T shape duct with laparoscopy. One patient of pancreatic head carcinoma died in MSOF postoperation 15 days. Conclusion Eventually it was safe and effective for some patients who had completed successful duct clearance and the dilation of the stenosis to reach the expected expansion adopted bile duct incision primary closure in laparoscopic bile duct exploration.
Keywords:Laparoscopy  Common bile duct exploration  Primary closure
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