正文 腹腔鏡膽總管切開取石後一期縫合治療膽總管結石療效觀察(1 / 3)

腹腔鏡膽總管切開取石後一期縫合治療膽總管結石療效觀察

外科醫學

作者:甄傑生 袁超傑 蔡世少

[摘要] 目的 探討腹腔鏡膽總管切開取石術後一期縫合治療膽總管結石的臨床療效。 方法 選取2010~2013年我院收治的膽總管結石患者30例,隨機分為對照組及觀察組,對照組行四孔法手術,術後留置T管、腹腔引流管,腹腔鏡直視下留置入膽總管並間斷縫合膽總管,觀察組則選取經B超或者MRI膽管造影證實膽總管結石存在的患者切開取石後一期縫合,對比兩組患者的手術時間、出血量、術後腸恢複時間以及並發症等。 結果 兩組患者在手術時間、出血量、恢複時間以及並發症發生率方麵差異有統計學意義(P

[關鍵詞] 腹腔鏡;膽總管;切開取石術;一期縫合;膽總管結石

[中圖分類號] R657.42 [文獻標識碼] B [文章編號] 1673-9701(2015)08-0040-03

[Abstract] Objective To investigate the clinical efficacy of laparoscopic common bile duct stone treatment of choledocholithiasis after primary suture. Methods Selected from 2010 to 2013 of 30 patients with choledocholithiasis in our hospital, and they were randomly divided into control group and observation group, the control group for 4 hole method of operation, T tube, peritoneal drainage after surgery, laparoscopic common bile duct retained into and interrupted suture of common bile duct, while the observation group was selected by the B ultrasound or MRI cholangiography confirmed the presence of common bile duct stones in patients after lithotomy suture. Operation time, bleeding volume, postoperative recovery time, complications and other aspects of the situation in two groups were compared. Results The two groups patients in the operation time, bleeding volume, recovery time and the complication rate had statistically significant difference(P

[Key words] Laparoscopy; Common bile duct; Lithotomy; Primary suture; Common bile duct stones

隨著腹腔鏡以及膽道鏡領域設備的進步以及技術的發展,使用腹腔鏡行膽總管切開取石成為臨床上治療膽總管結石的重要手術方式[1],不過傳統上的切開術後要留置T管,這就給患者帶來了額外的創傷及痛苦,同時也給患者帶來嚴重的生理及心理負擔。我院在行膽總管切開取石手術之後[2],為了進一步降低對患者的創傷,在切開取石後對患者進行一期縫合治療,取得理想效果,現報道如下。

1 資料與方法

1.1一般資料

選取2010~2013年我院收治的膽總管結石患者30例,其中男17例,女13例,患者年齡32~67歲,平均45歲。隨機分為對照組、觀察組各15例,對照組行4孔法手術,術後留置T管、腹腔引流管,腹腔鏡直視下留置入膽總管並間斷縫合膽總管,觀察組則選取經B超或MRI膽管造影證實膽總管結石存在的患者切開取石後一期縫合,並且膽總管直徑>1.0 cm,確認患者膽道的下端通暢,無括約肌病變,同時膽總管內壁沒有顯著糜爛以及水腫等炎症表現,排除結石複發以及有膽道手術病史患者[3]。兩組患者在病情、年齡、性別等方麵比較差異無統計學意義(P>0.05)。

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