腹腔镜胆总管探查一期缝合41例报告

目的 探讨腹腔镜胆总管切开检查免置T管的可行性及病例选择.方法 选择性地对41例有胆总管探查指征的病人在术中行腹腔镜、胆道镜双镜联合胆总管切开取石后行胆总管一期缝合,回顾性分析其手术的可行性.结果 本组41例全部治愈出院,引流管1～2d拔出.术后发生胆漏1例,术后5d拔出引流管.无胆道狭窄及腹腔感染病例.结论 若术者腹腔镜、胆道镜技术熟练,手术病例选择适当,术中检查仔细,冲洗干净,一期缝合是安全可行的.

Feasibility of primary suture of common bile duct following exploration of the common bile duct by laparoscopy and choledochoscopy

Objective To investigate the feasibility of free T-tube during the choledochoscopic operation and case selection.Methods Forty-one patients who had indication of exploration of the common bile duct were subjected to primary suture of common bile duct following calculus removed by laparoscopy and choledochoscopy in combination with common bile duct discission and the feasibility of this surgical procedure was analyzed.Results All 41 cases were cured and the drainage tube was extracted 1-2 days after operation.Biliary leakage occurred in one case and the drainage tube was extracted 5 days after operation.No bile duct stricture and peritoneal infection occurred.Conclusion Primary suture of common bile duct following exploration of the common bile duct by laparoscopy and choledochoscopy is safe and feasible.