腹腔镜胆总管探查一期缝合的临床研究

目的 探讨腹腔镜胆总管探查一期缝合的可行性和适应证及临床价值.方法 回顾性分析2007年7月-2010年10月72例胆管结石患者的临床资料,采用三孔法腹腔镜胆总管探查术,术中胆道镜配合胆道手术器械取石,一期缝合胆总管进行治疗.结果 72例手术均获成功,无中转开腹,4例出现术后胆漏,经腹腔引流3～5 d治愈,无严重并发症...

Clinical Study of Laparoscopic Common Bile Duct Exploration with Primary Suture

Objective To discuss the feasibility,indications and clinical value of laparoscopic common bile duct exploration with primary suture.Methods We analyzed the clinical data of 72 patients with biliary duct stone treated from July 2007 to October 2010.Three-port laparoscopic common bile duct exploration with primary suture was adopted;choledochoscopy and open bile duct operation instruments were used to take out the stones during the operation;and the common bile duct was treated with primary suture after operation.Results All operations were carried out successfully without any case of conversion to open operation.Bile leakage occurred in four cases and was cured with abdominal drainage tube for three to five days without any severe complications.Postoperative hospitalization time ranged from four to seven days,averaging at 4.4 days.All patients were followed up for one to 24 months（averaging at 10 months）.B-mode ultrasonography examination one month after operation showed no biliary tract stricture or residual stone.Conclusions Laparoscopic common bile duct exploration with primary suture is safe,reliable,minimally invasive,more effective,and can be regarded as an ideal operative method for the treatment of cholecystolithiasis combined with biliary duct stone in clinical practices.It is worth popularizing.The key elements for a successful operation lie in completely taking out the stones and having a sound knowledge of indications.Furthermore,surgeons should master the skills in choledochoscopy techniques,laparoscopic incision,suture and ligation.