可吸收线取代钛夹在腹腔镜胆囊切除术中的应用

目的探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中使用可吸收线取代钛夹结扎胆囊管和胆囊动脉的安全性。方法2003年1月~2009年1月,我院在852例LC术中采用可吸收线结扎胆囊管和胆囊动脉,分离胆囊三角,解剖出胆囊管和胆囊动脉,用分离钳将10cm左右带针的4-0可吸收线送入腹腔,在距胆总管0.5~1.0cm处分离钳将线绕过胆囊管及胆囊动脉,在腹腔镜内打三重结2个,在远端贴近胆囊颈再结扎一道,打结方法类似于普通持针器打结,在双线结之间切断胆囊管。结果852例手术均获得成功,无中转开腹。手术时间15~150min,平均42.3min;术中出血量5~100ml,平均11.6ml。647例术后随访3个月~3年,平均1.7年,无一例出现出血、胆漏和腹腔感染等并发症发生,未发生腹痛、黄疸及发热等症状。结论LC术中使用可吸收线取代钛夹处理胆囊管及胆囊动脉安全、可靠,能够有效地避免使用钛夹所致的并发症。

Replacement of Titanium Cilps by Absorbable Sutures in Laparoscopic Cholecystectomy

Objective To evaluate the safety of absorption sutures in stead of titanium clips in laparoscopic cholecystectomy(LC)for ligation of the cystic duct and artery.Methods From January 2003 to January 2009,we performed totally 852 cases of LC by using absorbable sutures to ligate the cystic duct and artery.During the surgery,after the Calot triangle was clearly separated,we ligated the cystic duct and artery at 0.5-1.0 cm to the bifurcation of the common bile duct by using 4.0# absorbable sutures with needles o...