腹腔镜胆总管切开取石一期缝合术(附29例报告)

目的:探讨腹腔镜胆总管切开取石一期缝合术的优点、方法及适应证。方法:应用腹腔镜手术设备及纤维胆道镜为29例胆总管结石患者行腹腔镜胆总管切开取石术,不置T管引流,一期缝合胆总管壁。结果:26例手术成功,平均手术时间98.2m in,术中平均出血15.3m l,术后平均肛门排气时间19.6h,术后平均住院8.3d,无胆漏等严重并发症发生,3例中转行腹腔镜胆总管切开取石T管引流术。结论:应用腹腔镜胆总管切开取石一期缝合术治疗胆管结石具有创伤小、住院时间短及并发症少的优势,对符合适应证的患者是一种安全、有效的术式,但应掌握操作技巧以提高手术成功率、防止胆漏的发生。

Evaluation of laparoscopic choledochotomy and primary ductal submucosa closure: with a report of 29 cases

Objective:To explore the value,method and indication of laparoscopic choledochotomy and primary ductal submucosa closure.Methods:The clinical data of twenty-nine patients with common bile duct calculi underwent laparoscopic choledochotomy and primary ductal submucosa closure without routine T-tube drainage was retrospectively analyzed.Results:Twenty-six cases were successfully accomplished the operation but 3 cases converted to T-tube drainage.The mean operating time,blood loss and postoperative hosptalization were 98.2min,15.3ml and 8.3d respectively.There were no severe complications occured in the patients who underwent primary closure.Conclusions:Laparoscopic choledochotomy and primary ductal submucosa closure has the advantage of less invasion,less complication and shorter hospitalization.It is a safe and effective operation for patients who have the indication.