倒刺缝线在腹腔镜胆总管囊肿切除术中的应用

目的初步探讨单向倒刺缝线在完全腹腔镜下成人胆总管囊肿切除术中应用的安全性及有效性。方法回顾性分析2012年8月-2014年10月期间行完全腹腔镜下成人胆总管囊肿切除术的10例病例资料。结果全组病例均成功完成手术,无中转开腹。手术时间（194.5±20）min,160～225 min,胆管空肠吻合时间为（19.1±4.0）min,13～25 min,空肠空肠吻合时间为（17.5±2.0）min,12～21 min。术中出血（64.0±43.2）ml,10～150 ml,下床活动时间（1.6±0.7）d,排气时间（2.5±0.7）d,术后住院时间（7.0±1.7）d,5～10 d10围手术期无并发症发生。10例均获得随访。随访时间2～26个月,平均随访12.7月。1例患者术后出现反流性胆管炎,经抗感染等治疗后痊愈。结论单向倒刺缝线用于完全腹腔镜下胆肠吻合是安全、有效的。可吸收倒刺缝线的应用能够降低腹腔镜下缝合难度、缩短缝合时间及手术时间、缩短学习曲线,有利于本术式的广泛开展。

Unidirectional barbed suture for totally laparoscopic choledochal cyst excision

Objective To explore the safety and effectivity of unidirectional barbed suture for totally laparoscopic choledochal cyst excision. Methods Retrospectively analyzed 10 cases treated by totally laparoscopic choledochal cyst excision from Aug. 2012 to Oct. 2014. Results All cases were successfully implemented of laparoscopic liver resection, no case was converted to open surgery. The length of the operation were （194.5 ±20） min, 160-225 min. The mean operative time to fashion the hepaticojejunal anastomosis was （ 19.1 ± 4.0 ） min, 13-25 min, and the jejunojejunal anastomosis was （ 17.5 ± 2.0） min, 12-21 min. Biliary leakage occurred in 1 patient, which recovered after drainage. The intraoperative blood loss was （64.0 ±43.2） ml, 10-150 ml, the postoperative ambulation was 1.6±0.7 d, the patients passed flatus in （2.5 ±0.7） d. The average hospital stay time after operation was （7.0 ±1.7） d, 5-10 d. All patients were followed up for 2-26 months （mean 12.7 months）. Reflux cholangitis occurred in 1 patient, which recovered after anti-infection. Conclusion The use of unidirectional barbed suture for totally laparoscopic choledochal cyst excision is safe and effective and reduce the degree of difficulty, shorten the operation, anastomosis time, and the learning curve.