腹腔镜胆总管探查术一期缝合胆总管的疗效观察

目的 探讨腹腔镜下胆总管一期缝合与留置T管引流的手术疗效.方法 回顾性分析本院2014年1月至2015年12月行腹腔镜胆道探查患者52例,其中一期缝合23例(观察组),留置T管29例(对照组),比较两组疗效.结果 两组患者手术时间、腹腔引流管拔除时间、肛门排气时间、术后并发症发生率比较差异无统计学意义(P＞0.05);观察组住院费用[(14 525.1±2 274.6)元]及术后住院时间[(4.9±1.5)d]明显低于对照组[(16 568.3±2 701.5)元、(7.4±2.1)d],两组比较差异有统计学意义(P＜0.05).结论 严格把握手术适应证,腹腔镜下胆囊切除+胆总管探查+胆道一期缝合是安全有效的手术方式,可提高疗效,加快患者恢复,缩短住院时间,提高生活质量.

Efficacy observation of primary sutures of common bile duct after laparoscopic common bile duct exploration

Objective To investigate the surgical efficacy of primary sutures of common bile duct and indwelling of a T-tube for drainage after laparoscopic common bile duct exploration (LCBDE).Methods A total of 52 patients undergoing LCBDE in our hospital from January 2014 to December 2015 were analyzed retrospectively,including primary sutures in 23 patients (the observation group) and indwelling of a T-tube in 29 patients (the control group),and the therapeutic efficacy between the two groups were compared.Results There were no statistically significant differences in operation time,the time for the removal of the abdominal drainage tube,the time of anal exhaust,and the incidence of postoperative complications between the two groups (P＞0.05).The hospitalization costs [(14 525.1±2 274.6)yuan] and postoperative hospital stay [(4.9±l.5)d] in the observation group were significantly lower than those in the control group [(16 568.3±2 701.5)yuan,(7.4±2.1) d],with statistically significant differences (P＜0.05).Conclusions Strict control of the indications for surgery,laparoscopic cholecystectomy + common bile duct exploration + primary sutures of the bile duct represent a safe and effective surgical approach,which can improve the therapeutic outcomes,accelerate patients' recovery,shorten patients' hospital stay,and improve patients' quality of life.