经腹腔镜胆总管探查一期缝合术

目的探讨经腹腔镜电视胆道镜胆总管探查一期缝合的合理性。方法自2002年4月至2005年4月间行经腹腔镜电视纤维胆道镜胆总管探查一期缝合术65例(腹腔镜组),行开腹电视纤维胆道镜胆总管探查一期缝合术132例(开腹组),比较这两种手术方式的治疗效果。结果腹腔镜组平均手术后住院时间为4d,开腹组术后平均住院时间为8d,两组比较有显著性差异(P<0.01)。腹腔镜组2例(2/65)出现胆漏,开腹组3例(3/132)出现胆漏,两组比较无显著性差异(P>0.05)。结论经腹腔镜胆电视胆道镜探查后对选择性病例行胆总管一期缝合是安全和有效的,值得推广应用。

Primary common bile duct closure after exploration with laparoscopic video cholangioscopy

Objective To investigate the rationality of primary common bile duct (CBD) closure after exploration with video cholangioscopy for bile stone. Methods Between April 2002 and April 2005, primary CBD closure after exploration with video cholangioscopy were performed on 197 cases for bile duct stone, of which 65 cases were performed laparoscopically (laparoscopic group), 132 cases by open procedure (open group). Results (1) The average postoperative hospital stay was 4 days for the laparoscopic group, 8 days for the open group (P< 0.01); (2) Postoperative bile leakage was seen in 2 cases (2/65) in the laparoscopic group and 3 cases (3/132) in the open group (P> 0.05). Conclusion Primary CBD closure after exploration with laparoscopic video cholangioscopy is a safe, effective and inexpensive alternative to open surgery in selected patients with bile duct calculi.